NPIMap

Individual provider Active NPI

Curtis A Jackson, MSW,RCSWI,CCFC,CCBT

  • Clinical Social Worker
  • Oakland Park, FL
National Provider Identifier
1811398167
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11760 Issued in FL
Practice address
2901 W Oakland Park Blvd
Oakland Park, FL 33311
Phone
(954) 202-9334
NPI assigned
Sep 5, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Social Worker 104100000X
Clinical Social Worker 1041C0700X 11760 FL Primary

Addresses

Primary practice location

2901 W Oakland Park Blvd
Oakland Park, FL 33311

Mailing address

2860 NW 187TH St
Miami Gardens, FL 33056-3131
Phone (786) 991-6067

Other practice location 1

4330 W Broward Blvd
Plantation, FL 33317-3775
Phone (954) 797-1617

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
11760FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stay Stopped Recovery Support Servicies Inc Past Accepting new patients
Total Family Health Care Center Inc Mental Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1811398167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 NW 187TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330563131",
            "telephone_number": "786-991-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W OAKLAND PARK BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "33311",
            "telephone_number": "954-202-9334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4330 W Broward Blvd",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333173775",
            "country_code": "US",
            "telephone_number": "954-797-1617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CURTIS",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MSW,RCSWI,CCFC,CCBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-05",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "11760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.