Debbie Lea Jackson, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0008164 Issued in OH

Practice address

1101 Johnson Ave Ste 2
Myrtle Beach, SC 29577-1893

Phone

(843) 477-0177

NPI assigned

Mar 4, 2010

Last updated

Feb 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in OH

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

• Cleveland Psychiatry Associates LLC

  • Psychiatry Physician
  • Brecksville, OH
  • NPI 1982984944
  Medicare reassignment NPD
• Garden Path Counseling, LLC

  dba Garden Path Counseling

  • Professional Counselor
  • Pawley's Island, SC
  • NPI 1790463537
  NPD (past)

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1346563350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 JOHNSON AVE STE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771893",
            "telephone_number": "843-477-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JOHNSON AVE STE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771893",
            "telephone_number": "843-477-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DEBBIE",
        "middle_name": "LEA",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0008164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Isom, EDD, LPC
• Amy E Ivey, CCC-SLP
• Michael Ivey
• J & S Senior Services LLC (ComForcare Senior Services-Mrytle Beach)
• J. Wade Nichols DMD, PA
• Janet Leah Jackson
• Jared Andrew Jackson, MD
• Jeffrey Jackson, LGSW
• Krista Jackson
• Mary Taylor Britt Jackson, FNP

• Clinical Social Worker in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.