Active NPI
Laura K Jackson, LCSW; LCDC III
- Clinical Social Worker
- Covington, KY
National Provider Identifier
1326224288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW 3952
- Practice address
- 3629 Church St
Covington, KY 41015-1430 - Phone
- (859) 581-8974
- Fax
- (859) 581-9595
- NPI assigned
- Jan 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW 3952 | KY | Primary |
| Clinical Social Worker | 1041C0700X | LSW-09000933 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDC III- 101140 | OH |
Addresses
Primary practice location
3629 Church St
Covington, KY 41015-1430
Mailing address
3629 Church St
Covington, KY 41015-1430
Phone (859) 581-8974
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCDC III- 101140 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| LCSW 3952 | KY | MD | Clinical Social Worker |
| LSW-09000933 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Charities, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412035200000",
"number": "1326224288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3629 CHURCH ST",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410151430",
"telephone_number": "859-581-8974",
"fax_number": "859-581-9595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3629 CHURCH ST",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410151430",
"telephone_number": "859-581-8974",
"fax_number": "859-581-9595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LAURA",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "LCSW; LCDC III",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-10",
"last_updated": "2014-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "LCSW 3952",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "LSW-09000933",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LCDC III- 101140",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.