Julie Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW23744 Issued in FL

Practice address

1423 Oakfield Dr
Brandon, FL 33511-2801

Phone

(813) 695-3467

NPI assigned

Mar 27, 2023

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 FL

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Neuropsychology, LLCGroup PAC ID 7810142254, 7 clinicians

Practice addresses (Care Compare)

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.

• Bay Area Neuropsychology, LLC

  • Psychologist
  • Tampa, FL
  • NPI 1790023851
  Medicare reassignment Care Compare group
• Thin Line Counseling LLC

  • Mental Health Counselor
  • Brandon, FL
  • NPI 1689320756
  NPD

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1669175774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10335 SUMMER AZURE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335785812",
            "telephone_number": "805-895-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335112801",
            "telephone_number": "813-695-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JULIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yudisnay Izquierdo Fiallo
• J Ting MD Inc
• J. Paonessa M.D. P.a.
• Carrie Jacka
• Ebene Jackson, RBT
• Manami Jackson
• Martie Marie Jackson, ARNP
• Rhonda S Jackson, ARNP
• Trenichia Jackson
• Leslie Jacobi

• Clinical Social Worker in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.