Tarica Rashaun Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.024421 Issued in IL

Practice address

228 Evelyn Ave Apt 3
Loves Park, IL 61111-5097

Phone

(779) 220-0223

Fax

(888) 668-1804

NPI assigned

Mar 29, 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

Enrolled in IL

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

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.

• Faith Moves Mountains Counseling and Therapy LLC

  • Clinical Social Worker
  • Loves Park, IL
  • NPI 1477386332
  Medicare reassignment NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1598405722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 EVELYN AVE APT 3",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115097",
            "telephone_number": "779-220-0223",
            "fax_number": "888-668-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 EVELYN AVE APT 3",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115097",
            "telephone_number": "779-220-0223",
            "fax_number": "888-668-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TARICA",
        "middle_name": "RASHAUN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.024421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Huls, LMT
• Ibrahim Ibrahim, M.D.
• Benedict Ikeudenta III, MD
• Illinois Mentor
• Sheila Isit, PHARMACIST
• Salli Jacobsen
• Samuel Janczak, LMT
• Leah Jankowski, M.ED, ATC
• Javid Iqbal
• John M. Jaworowicz, M.D.

• Clinical Social Worker in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.