Active NPI
Michele Jackson, LMSW
- Social Worker
- Harker Heights, TX
National Provider Identifier
1669031753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 64908
- Practice address
- 2306 Verona CT
Harker Heights, TX 76548-8855 - Phone
- (912) 572-7273
- NPI assigned
- Jun 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P013052 | NC | |
| Social Worker | 104100000X | 64908 | TX | Primary |
Addresses
Primary practice location
2306 Verona CT
Harker Heights, TX 76548-8855
Mailing address
2306 Verona CT
Harker Heights, TX 76548-8855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P013052 | NC | MD | Clinical Social Worker |
| 64908 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1669031753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2306 VERONA CT",
"city": "HARKER HEIGHTS",
"state": "TX",
"postal_code": "765488855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2306 VERONA CT",
"city": "HARKER HEIGHTS",
"state": "TX",
"postal_code": "765488855",
"telephone_number": "912-572-7273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MICHELE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-11",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P013052",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "64908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harker Heights, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.