Markus K Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004900A Issued in IN

Practice address

105 E Jefferson Blvd
Suite 700
South Bend, IN 46601-1922

Phone

(574) 232-2255

Fax

(574) 287-9377

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1518955434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E JEFFERSON BLVD",
            "address_2": "SUITE 700",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011922",
            "telephone_number": "574-232-2255",
            "fax_number": "574-287-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E JEFFERSON BLVD",
            "address_2": "SUITE 700",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011922",
            "telephone_number": "574-232-2255",
            "fax_number": "574-287-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MARKUS",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004900A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN PSYCH SYSTEMS",
            "identifier": "PVPB106032",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000368745",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amar Zierre Jackson
• Angela Decarla Jackson, PH.D., LCPC, LMHC
• Annitta Jackson, LPN
• Dandray Isaiah Jackson I
• Joann Michelle Jackson, PSY.D.
• Matthew Jackson
• Mikayla Jackson
• Sandra J Jackson, LCAC CADAC IV NADAC
• Shannon Jackson, REHAB TECH
• Michael Jacob

• Clinical Social Worker in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.