Elisha D Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 26325 Issued in CA

Practice address

240 East 20TH Street
Long Beach, CA 90806

Phone

(562) 218-4098

Fax

(562) 218-4076

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1487721817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44417",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900440417",
            "telephone_number": "562-218-4098",
            "fax_number": "562-218-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 EAST 20TH STREET",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-218-4098",
            "fax_number": "562-218-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELISHA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "16946",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 26325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claryn Jackson
• Danielle Ni'Kole Jackson
• Debresia Jackson
• Destanie Jackson
• Douglas W Jackson, M.D.
• Francine Jackson, D.D.S.
• Imunique Kyran Jackson
• Jack Phillip Jackson
• Janell Jackson
• Jessica Lee Jackson

• Clinical Social Worker in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.