Active NPI
Lesley Jackson
- Clinical Social Worker
- Wilton Manors, FL
National Provider Identifier
1467022897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 819 NE 26TH St
Wilton Manors, FL 33305-1239 - Phone
- (954) 390-7654
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
819 NE 26TH St
Wilton Manors, FL 33305-1239
Mailing address
819 NE 26TH St
Wilton Manors, FL 33305-1239
Phone (954) 390-7654
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lesleyjackson@kidinc.org |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1467022897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 NE 26TH ST",
"city": "WILTON MANORS",
"state": "FL",
"postal_code": "333051239",
"telephone_number": "954-390-7654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 NE 26TH ST",
"city": "WILTON MANORS",
"state": "FL",
"postal_code": "333051239",
"telephone_number": "954-390-7654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "LESLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-28",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lesleyjackson@kidinc.org",
"affiliation": "N",
"address_1": "819 NE 26th St",
"city": "Wilton Manors",
"state": "FL",
"country_code": "US",
"postal_code": "333051239",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Wilton Manors, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.