Joy A Jackson, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1101049 Issued in OH

Practice address

11801 Buckeye Rd
Cleveland, OH 44120-2620

Phone

(216) 831-2255

Fax

(216) 378-3906

NPI assigned

Apr 6, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Joy A Lane Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Families First Health Services

  • Community/Behavioral Health Agency
  • Independence, OH
  • NPI 1356711477
  Medicare reassignment NPD
• Genesis Behavioral Services Incorporated

  • Mental Health Counselor
  • Euclid, OH
  • NPI 1265994982
  Medicare reassignment NPD
• Beech Brook

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cleveland, OH
  • NPI 1437399474
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1235428780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201058",
            "telephone_number": "216-923-0333",
            "fax_number": "216-923-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 BUCKEYE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202620",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JOY",
        "middle_name": "A",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.0901107",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014568",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "106816",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1101049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268768",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02686768",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cleveland",
            "affiliation": "N",
            "endpointDescription": "j.jackson@ascendsolutions.org",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12200 Fairhill Rd",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441201058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOY",
            "last_name": "LANE",
            "middle_name": "A",
            "credential": "LISW-S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jarell R Jackson
• Jennifer Linnette Jackson
• Joan Jackson
• Joann Jackson, MD
• John Jackson, QMHS
• Julia Jackson
• Julie Terese Jackson, LSW
• Kadijah C Jackson, RN
• Kalana Latriece Jackson, STNA
• Kathy Joy Jackson, MSSA, LSW

• Clinical Social Worker in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.