Individual provider Active NPI

Sierra Jackson

  • Clinical Social Worker
  • Wesley Chapel, FL
National Provider Identifier
1720886591
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24330 Issued in FL
Practice address
2240 Twelve Oaks Way Ste 101
Wesley Chapel, FL 33544-6970
Phone
(813) 838-4807
NPI assigned
Mar 6, 2025
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW24330 FL Primary

Addresses

Primary practice location

2240 Twelve Oaks Way Ste 101
Wesley Chapel, FL 33544-6970

Mailing address

6772 High Knoll Dr
Lakeland, FL 33813-1859

Other practice location 1

6772 High Knoll Dr
Lakeland, FL 33813-1859
Phone (863) 617-4596

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

LicenseStateTypeSpecialty
SW24330FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
As We Grow Counseling, PA Clinical CurrentSince Mar 11, 2025 Accepting new patients

Locations

2240 Twelve Oaks Way
Ste 101
Wesley Chapel, FL 33544
Phone (813) 442-2971

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1720886591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6772 HIGH KNOLL DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 TWELVE OAKS WAY STE 101",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446970",
            "telephone_number": "813-838-4807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6772 High Knoll Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338131859",
            "country_code": "US",
            "telephone_number": "863-617-4596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SIERRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.