Stephanie C Jackson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801095974 Issued in MI

Practice address

616 W Broad St
Linden, MI 48451-8645

Phone

(810) 936-0079

NPI assigned

Jul 15, 2009

Sex

Female

Sole proprietor

No

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

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Road2Wellness PLLCGroup PAC ID 3173979879, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Road2Wellness PLLC

  • Clinical Social Worker
  • Linden, MI
  • NPI 1811648678
  Medicare reassignment Care Compare group NPD
• Genesys Practice Partners, Inc.

  • Psychiatry Physician
  • Grand Blanc, MI
  • NPI 1962423186
  NPD (past)

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1497985113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W BROAD ST",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518645",
            "telephone_number": "810-936-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W BROAD ST",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518645",
            "telephone_number": "810-936-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "STEPHANIE",
        "middle_name": "C",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Elliott, LMSW
• Harrison Complete Home Care
• Kimberly Henson
• Laura Hinman
• Margaret Dryden Hogan, RDN
• Jeremy M Grove DDS PLLC
• Jeremy M Grove DDS PLLC
• Melissa Ann Johns, LMT, PTA, CDP
• Nancy Jones, MSPT
• Michael Alan Kaines, DDS

• Clinical Social Worker in Linden, MI
• Providers in Linden, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.