Jacqueline Mayes Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW002881 Issued in GA

Practice address

2904 Harvest LN
Albany, GA 31721-4555

Phone

(229) 449-0805

Fax

(229) 449-0805

NPI assigned

Feb 6, 2007

Last updated

Oct 4, 2013By the provider in NPPES

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 GA

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life Solutions Counseling Services, LLC

  • Clinical Social Worker
  • Macon, GA
  • NPI 1043857618
  Medicare reassignment NPD Authorized official
• Senior Psych Solutions Corp

  • Clinical Social Worker
  • Atlanta, GA
  • NPI 1225078629
  NPD (past)
• Therapeutic Collaborative, LLC

  • Clinical Social Worker
  • Albany, GA
  • NPI 1598808438
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1639218480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 LAMAR RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312107109",
            "telephone_number": "229-449-0805",
            "fax_number": "229-449-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 HARVEST LN",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317214555",
            "telephone_number": "229-449-0805",
            "fax_number": "229-449-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JACQUELINE",
        "middle_name": "MAYES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW002881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamala Jackson-Rowe, MS, MED
• Cassandra Lavette Jackson
• Chantileer Jackson, APN
• Constance Jackson, LPC
• Edwina Sue Jackson, RN
• Jaquella Jackson, MSW
• Joanna Louise Jackson
• Joseph M Jackson III, MD
• Latonya Monique Jackson, LPN
• Leigh Anne Jackson, PHARMD

• Clinical Social Worker in Albany, GA
• Providers in Albany, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.