Tabetha Nicole Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007907 Issued in NC

Practice address

513 Amerson CT # B
Nashville, NC 27856-1151

Phone

(252) 955-3744

NPI assigned

Oct 18, 2021

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

Electronic endpoints 1

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1588327555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 AMERSON CT # B",
            "city": "NASHVILLE",
            "state": "NC",
            "postal_code": "278561151",
            "telephone_number": "252-955-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 AMERSON CT # B",
            "city": "NASHVILLE",
            "state": "NC",
            "postal_code": "278561151",
            "telephone_number": "252-955-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TABETHA",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Betterhelp.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "513 Amerson Ct # B",
            "city": "Nashville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278561151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan L Hester, COTA/L
• Autumn Pilgreen Holloman, OTR/L
• Home Strong Home Care LLC
• Joshua Mitchell Horlick
• Howard M. Baker, Jr., DDS, PA
• Michelle Jacobsen, MSOTR/L
• Kelly Shaffer Jenkins, PT
• Erin Smith Johnson, PTA
• Kourtnie Johnson, LCSWA
• Tekeyla Thomas Jones, LCMHCA

• Clinical Social Worker in Nashville, NC
• Providers in Nashville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.