Mary A Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0906006974 Issued in VA

Practice address

435 Merchant Walk SQ
Ste 300 - 624
Charlottesville, VA 22902-5729

Phone

(434) 217-0720

NPI assigned

Feb 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Heart of Hope Mental Health and Wellness, PLLC

  • Clinical Social Worker
  • Charlottesville, VA
  • NPI 1407546286
  NPD Authorized official
• Healthy Minds Therapy PLLC

  • Family Psychologist
  • Alexandria, VA
  • NPI 1831606730
  NPD (past)

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1235760786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 MERCHANT WALK SQ",
            "address_2": "STE 300 - 624",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229026514",
            "telephone_number": "434-217-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 MERCHANT WALK SQ",
            "address_2": "STE 300 - 624",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025729",
            "telephone_number": "434-217-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0906006974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Thompson Jackson, M.DIV.
• Katrina E Jackson, LSA, CSFA
• Kayla Jackson, LCSW
• Keith Daniel Jackson, DMD
• Mackenzie Jackson
• Mary Jane Jackson, R.N., N.P.
• Megan Jackson, DC
• Nina Jackson, PT
• Patrick E Jackson, MD
• Amelia Jacokes, LCSW

• Clinical Social Worker in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.