Individual provider Active NPI

Gillian Jackson

  • Clinical Social Worker
  • Cornelius, NC
National Provider Identifier
1336052729
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P024540 Issued in NC
Practice address
19901 W Catawba Ave Ste 202
Cornelius, NC 28031-4043
Phone
(980) 728-1008
NPI assigned
Sep 25, 2026
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P024540 NC Primary

Addresses

Primary practice location

19901 W Catawba Ave Ste 202
Cornelius, NC 28031-4043

Mailing address

3820 Lampasas LN
Charlotte, NC 28214-3812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1336052729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 LAMPASAS LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282143812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19901 W CATAWBA AVE STE 202",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314043",
            "telephone_number": "980-728-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P024540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.