Cheryl Ann Jackson, LMSW, CAADC, CCS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801092435 Issued in MI

Practice address

2901 S Ethel St
Detroit, MI 48217-1531

Phone

(313) 775-6335

NPI assigned

Oct 1, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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.

• Detroit Central City Community Mental Health Inc.

  dba Central City Health

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1285043406
  Medicare reassignment NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  MI

  Medicare reassignment NPD
• Everlasting Hope PLLC

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1871029546

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official
• Detroit Central City Community Mental Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1598502817
  NPD

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1265741789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 S ETHEL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482171531",
            "telephone_number": "313-775-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 S ETHEL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482171531",
            "telephone_number": "313-775-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "credential": "LMSW, CAADC, CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayana Kai Jackson
• Beverly Joyce Jackson, REGISTERED NURSE
• Briggittee Jackson
• Charlyn Jackson
• Cheryl Jackson, CNP
• Christine Jackson, LMSW
• Cornell Lee Jackson
• Crystal A. Jackson, PH.D., LLP
• Cynthia Linnea Jackson, LM, CPM
• Dairrus M Jackson

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.