Deja De'Shea Jackson, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

34 Oleander Dr
Clayton, NC 27527-4599

Phone

(919) 243-1505

NPI assigned

May 19, 2021

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• Calm and Focused Therapy PLLC

  • Clinical Social Worker
  • Garner, NC
  • NPI 1033921119
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1336713684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 OLEANDER DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275274599",
            "telephone_number": "910-489-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 OLEANDER DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275274599",
            "telephone_number": "919-243-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DEJA",
        "middle_name": "DE'SHEA",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Into the Light Counseling, Inc.
• William Spencer Irving, LCMHC-A
• Monette Irwin, L.C.S.W.
• Alexis Jackson, MA, BCBA, LBA
• Carmesia Jackson
• Erica Boswell Jackson
• Sharon Rena Jackson
• Jacob'S Ladder Childhood Therapy
• Jacqueline Wardrett
• Jak Counseling Services

• Clinical Social Worker in Clayton, NC
• Providers in Clayton, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.