Stefani Michon Jackson, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24016 Issued in MD

Practice address

880 Sunny Lake Dr
Lawrenceville, GA 30043-4562

Phone

(301) 284-8176

NPI assigned

Oct 6, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• B-Yourbest Women'S Wellness & Christian Counseling, LLC

  • Clinical Social Worker
  • Lawrenceville, GA
  • NPI 1629886759
  NPD Authorized official

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1669134839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 ROCKVILLE PIKE STE 1043",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208521601",
            "telephone_number": "301-284-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SUNNY LAKE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434562",
            "telephone_number": "301-284-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "STEFANI",
        "middle_name": "MICHON",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "24016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keilon Latrice Jackson, CMA
• Kelly Len Jackson, N.P.
• Marshalee Jackson
• Rebecca Dott Jackson, PA-C
• Shqunna Renee Jackson, RN
• Tiki Jackson, LMSW
• Wroksie Jackson, LCSW
• Leslie Jacobs
• Lloydstone Leonard Jacobs II, M.D.
• Sara Susan Jacobsen, M.D.

• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, 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 Dec 16, 2024; 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.