Elizabeth Sheree Jackson, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1904068 Issued in OH

Practice address

2640 Saint Charles Ave
Dayton, OH 45410-3147

Phone

(937) 586-0435

NPI assigned

Aug 29, 2019

Sex

Female

Sole proprietor

No

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

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/recoveryworkshealingcenter/r4/

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.

• Recovery Works Holding Company LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dayton, OH
  • NPI 1376910505
  NPD (past)
• Recovery Works Holding Company LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
  • NPI 1801316971
  NPD (past)

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1609424902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 SAINT CHARLES AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454103147",
            "telephone_number": "937-586-0435",
            "fax_number": "937-890-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 SAINT CHARLES AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454103147",
            "telephone_number": "937-586-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ELIZABETH",
        "middle_name": "SHEREE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2023-04-06",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1904068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawanya Jackson
• Deborah Gail Jackson, LMT
• Deborah M Jackson, CARE GIVER
• Deshae Renee Jackson, CD(DONA)
• Devonna C. Jackson
• Jalyssa Jackson
• Jasmine Nicole Jackson, LPN
• Jason Jackson
• Jennifer L Jackson, DO
• Jeremy Jackson, D.O., M.P.H.

• Social Worker in Dayton, OH
• Providers in Dayton, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.