Individual provider Active NPI

Janice Jackson, LGSW

  • Social Worker
  • Hyattsville, MD
National Provider Identifier
1639349582
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
G12541 Issued in MD
Practice address
6475 New Hampshire Ave
Hyattsville, MD 20783-3269
Phone
(301) 270-3200
NPI assigned
Mar 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50082372 DC
Social Worker 104100000X G12541 MD Primary

Addresses

Primary practice location

6475 New Hampshire Ave
Hyattsville, MD 20783-3269

Mailing address

8418 Branchwood Cir
Clinton, MD 20735-2155
Phone (301) 856-8251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20250604001636 DC Practitioner - Clinical Social Worker 2769991306 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G12541MDMDSocial Worker
LC50082372DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince May 8, 2025 Accepting new patients

Locations

601 Pennsylvania Ave NW
Washington, DC 20004
Phone (202) 638-6942

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1639349582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8418 BRANCHWOOD CIR",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352155",
            "telephone_number": "301-856-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 NEW HAMPSHIRE AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207833269",
            "telephone_number": "301-270-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JANICE",
        "name_prefix": "Ms.",
        "credential": "LGSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50082372",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "G12541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

Verify at the official NPI Registry.