Delqwan Rashawn Jackson, MSW, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P016902 Issued in NC

Practice address

110 Glenburnie LN Apt 103
Durham, NC 27704-3073

Phone

(919) 908-3072

NPI assigned

Apr 29, 2022

Sex

Male

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

State licenses

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.

• Courageous Mind Counseling and Wellness, PLLC

  • Clinical Social Worker
  • Durham, NC
  • NPI 1568306223
  NPD Authorized official

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1386389807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 GLENBURNIE LN APT 103",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277043073",
            "telephone_number": "919-908-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 GLENBURNIE LN APT 103",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277043073",
            "telephone_number": "919-908-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DELQWAN",
        "middle_name": "RASHAWN",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Jackson, RDN
• Bethena M Jackson, CSAC, LCAS-A
• Brooke A Jackson, MD
• Carrie Ann Jackson, M.ED
• Christy Jackson, RD, LDN
• Diamond Mone Jackson, PT, DPT
• George William Jackson, MD
• Irene Dormenie Jackson, LCMHC, LCAS-A
• Jessica Jackson, PA-C
• Joseph A. Jackson, MD

• Clinical Social Worker in Durham, NC
• Providers in Durham, 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 Apr 29, 2022; 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.