Alyssa Jackson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS50078247 Issued in DC

Practice address

1112 16TH St NW
Ste 600
Washington, DC 20036

Phone

(202) 660-1319

NPI assigned

Nov 23, 2020

Last updated

Jun 29, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Consulting

  • Social Worker
  • Washington, DC
  • NPI 1255082384
  NPD
• Rooted in Healing LLC

  • Clinical Social Worker
  • Bowie, MD
  • NPI 1336920909
  NPD

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1275137093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 K ST NW STE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061631",
            "telephone_number": "240-224-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 16TH ST NW",
            "address_2": "STE 600",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20036",
            "telephone_number": "202-660-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALYSSA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LG50082408",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LCS50078247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Jackson
• Alexus Jackson
• Alicia Jackson
• Allison M Jackson, MD, MPH
• Alvoncia Shovon Jackson
• Andraya Storm Jackson, CTRS
• Andre Jackson
• Andrea Brown Jackson, LPC
• Andrea Lane Jackson, LICSW, LCSW
• Antoinette Jackson, LPC

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.