Elisabeth Jackson, PH.D. LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

048800 Issued in NY

Practice address

1 Pierpont Plaza
Suite 12134
Brooklyn, NY 11246

Phone

(866) 650-2676

Fax

(212) 591-6091

NPI assigned

May 1, 2012

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

Other names 1

• Dr. Elisa English Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1407114150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 FIFTH AVE.",
            "address_2": "STE E249",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "866-650-2676",
            "fax_number": "212-591-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PIERPONT PLAZA",
            "address_2": "SUITE 12134",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11246",
            "telephone_number": "866-650-2676",
            "fax_number": "212-591-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D. LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "048800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "ENGLISH",
            "prefix": "DR.",
            "credential": "LCSWR, PH.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Davida Jackson
• Debra Jackson, LPN
• Deja Jackson
• Donnice Veronica Jackson
• Douglas Clarence Jackson, SUBSTANCE COUNSELOR
• Eric Jackson, B.S., M.S., CCC-SLP
• Gayle D Jackson, OT
• Henry Jackson, P.T.
• Indiara Shamera Jackson, MSW
• Jannieve Jackson Sr., M.A.

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.