Zina Jackson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21370 Issued in MN

Practice address

201 E Academy St
Fuquay Varina, NC 27526-2248

Phone

(833) 529-8270

NPI assigned

Apr 22, 2013

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

Enrolled in CA

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.

• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paso Robles, CA
  • NPI 1134287634
  Medicare reassignment NPD
• Light to Wellness Therapy and Consulting Services LLC

  • Clinical Social Worker
  • Saint Peters, MO
  • NPI 1194468298
  NPD Authorized official
• County of San Luis Obispo

  • Adolescent and Children Mental Health Clinic/Center
  • San Luis Obispo, CA
  • NPI 1396803870
  NPD
• County of San Luis Obispo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arroyo Grande, CA
  • NPI 1932563053
  NPD

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1639513617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E ACADEMY ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262248",
            "telephone_number": "833-529-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E ACADEMY ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262248",
            "telephone_number": "833-529-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ZINA",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Instride Foot and Ankle Specialists, PLLC
• Integrative Pediatric Therapy P.C.
• Integrative Sleep Wake Health, PLLC
• Iron Varsity, LLC
• Charlotte Bell Jackson, MPH, RD, LDN
• Hayley F Jacobs
• Melanie Jacobs, COTA/L
• Michael Jacobs IV, FNP-BC
• Rachel Anne Jaffry
• James S McKenzie DDS PA

• Clinical Social Worker in Fuquay Varina, NC
• Providers in Fuquay Varina, 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 Dec 9, 2025; 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.