Gabrielle Jackson, LICSW, LCSW, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17526 Issued in MD

Practice address

6710 Oxon Hill Rd Ste 210
Oxon Hill, MD 20745-1124

Phone

(202) 929-4286

Fax

(202) 929-6309

NPI assigned

Feb 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1790241339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 OXON HILL RD STE 210",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451124",
            "telephone_number": "202-929-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 OXON HILL RD STE 210",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451124",
            "telephone_number": "202-929-4286",
            "fax_number": "202-929-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "GABRIELLE",
        "credential": "LICSW, LCSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009476",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080738",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imed Surgical of Oxon Hill PC
• Integrated Mental Health Services, LLC
• Iradj Sadeghian MD & Associates
• Kafayat Folake Iyanda, DPT
• Dana C. Jackson, DDS
• Lakeisha Renee Jackson, LCSW-C
• Niesha Yolanda Jackson
• Jafar Nazemian M.D. P.a.
• Jalal Saied MD LLC
• James R Benjamin MD PA

• Clinical Social Worker in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.