Summer Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW71611 Issued in CA

Practice address

725 Neilson St
Berkeley, CA 94707-1813

Phone

(510) 406-4496

NPI assigned

May 17, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1588301022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1748 SHATTUCK AVE",
            "address_2": "PMB 154",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NEILSON ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947071813",
            "telephone_number": "510-406-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SUMMER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW71611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• De'Aunte Jackson
• Genee Delyene Jackson, PH.D.
• Helen Maria Jackson, M.D.
• Samirah Nasiha Jackson
• Shannon Michelle Jackson, MA
• Jacob Donnelly, Licensed Clinical Social Worker, Inc.
• Lynanne Jacob, R.N.
• Mack Jacob, DDS
• James Harris Jacobs, PH.D.
• Carl H. Jacobsen, O.D.

• Clinical Social Worker in Berkeley, CA
• Providers in Berkeley, 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 May 17, 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.

Verify at the official NPI Registry.