Nicole A Jackson, LCSW-C

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

22666 Issued in MD

Practice address

11810 Presgraves Rd
Reisterstown, MD 21136-3298

Phone

(443) 271-7449

NPI assigned

Jul 16, 2018

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not 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.

• A Change Will Come Counseling Services, LLC

  • Clinical Social Worker
  • Catonsville, MD
  • NPI 1396379111
  NPD Authorized official

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1528544251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11810 PRESGRAVES RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363298",
            "telephone_number": "443-271-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11810 PRESGRAVES RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363298",
            "telephone_number": "443-271-7449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 Taylor Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212868333",
            "country_code": "US",
            "telephone_number": "443-279-5829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NICOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22666",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MD",
            "license": "22666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iot Behavioral Health Center Inc
• Iot Behavioral Health Center Inc
• Franklin David Israel, MD
• It Takes a Village Counseling Consulting & Support Services LLC
• Nicholas Adam Jabco
• James a. Eickhoff and Harold D. Rowe, Partners
• James F. Dasinger Edd & Associates
• Amienata Jarra
• Diana Jebaraj
• Scott D. Jerome, D.O.

• School Social Worker in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• School Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.