Marilyn Sledge Jackson/Safe Harbor

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2160C Issued in AL

Legal business name

MARILYN SLEDGE JACKSON/SAFE HARBOR

Practice address

1040 Longfield CT
Montgomery, AL 36117-8055

Phone

(334) 288-9009

Fax

(334) 288-9497

NPI assigned

Jun 12, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Marilyn Sledge Jackson, LCSW/PIP

Title

Therapist

Phone

(334) 235-8158

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1750729646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 BRIAR GATE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162154",
            "telephone_number": "334-235-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 LONGFIELD CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178055",
            "telephone_number": "334-288-9009",
            "fax_number": "334-288-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN SLEDGE JACKSON/SAFE HARBOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "SLEDGE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "334-235-8158",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW/PIP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2160C",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "0942-2160C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo Mantovani Cardoso, MD
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• Marguerite J. Barber-Owens
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• Mark S Veres DPM
• Ann S. Markham, R.PH.
• Kimberly Marks

• Clinical Social Worker in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.