Individual provider Active NPI

Valerie F Jackson, LMSW, ACSW

  • Social Worker
  • Flint, MI
National Provider Identifier
1356471908
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801077180 Issued in MI
Practice address
G3163 Flushing Rd
Suite 214
Flint, MI 48504-4365
Phone
(810) 845-6465
Fax
(810) 733-7317
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801077180 MI Primary

Addresses

Primary practice location

G3163 Flushing Rd
Suite 214
Flint, MI 48504-4365

Mailing address

5418 Bright Creek CT
Flint, MI 48532-2254
Phone (810) 845-6465

Other identifiers 1

IdentifierTypeStateIssuer
8008976850OtherMIBC BS PIN

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Faith Counseling Center, LLC Current Accepting new patients
Michigan Employee Assistance Consultant PLLC Past Accepting new patients

Locations

G3163 Flushing Rd
Ste 214
Flint, MI 48504
Phone (810) 845-6465

Organizations & group practices 2

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1356471908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5418 BRIGHT CREEK CT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485322254",
            "telephone_number": "810-845-6465",
            "fax_number": "810-733-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3163 FLUSHING RD",
            "address_2": "SUITE 214",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485044365",
            "telephone_number": "810-845-6465",
            "fax_number": "810-733-7317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "VALERIE",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "LMSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801077180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PIN",
            "identifier": "8008976850",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.