Ashley J Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008469 Issued in CT

Practice address

30 Elizabeth St
Derby, CT 06418-1869

Phone

(203) 954-0543

NPI assigned

Aug 30, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ashley.jackson.p1@direct.wheelerclinic.nextgenshare.com

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.

• Silvia Sandoval, LCSW

  • Clinical Social Worker
  • Yalesville, CT
  • NPI 1003168360
  NPD (past)

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1790091544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CAPTAINS WATCH",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064845914",
            "telephone_number": "203-922-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ELIZABETH ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181869",
            "telephone_number": "203-954-0543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Truman St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065192022",
            "country_code": "US",
            "telephone_number": "475-220-2123",
            "fax_number": "475-220-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ASHLEY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008469",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhianon Noel Iassogna-Roman, APRN, RN
• In-Home Angels Adult Day LLC
• Peter J. Integlia, CRNA
• Internacional Clinical Services & Behavior Health Specialist
• Internal Medicine & Pediatrics LLC
• Don-Andre Jackson
• Megan Elizabeth Jackson, LMSW
• Jacquelyn Carrano, LCSW LLC
• Osman Arif Jaffer
• Hassam Jaffry, MD

• Clinical Social Worker in Derby, CT
• Providers in Derby, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.