Sedrick Wales Jackson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

41529 Issued in TX

Practice address

2000 East Lamar Blvd Suite 600
Arlington, TX 76006-7361

Phone

(214) 519-9473

Fax

(972) 236-0057

NPI assigned

Aug 28, 2016

Last updated

Aug 28, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wales Counseling Center, PLLC

  • Clinical Social Worker
  • Arlington, TX
  • NPI 1194958769
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1811443039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EAST LAMAR BLVD SUITE 600",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760067361",
            "telephone_number": "214-519-9473",
            "fax_number": "972-236-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 EAST LAMAR BLVD SUITE 600",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760067361",
            "telephone_number": "214-519-9473",
            "fax_number": "972-236-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SEDRICK",
        "middle_name": "WALES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "41529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra Karen Jackson, DDS
• Okeisha Jackson
• Paola Jackson
• Renee Jackson
• Robert Jackson, PTA
• Sonja Jackson, LPC
• Stacey Renee Jackson, NP
• Nimisha Jacob
• Sajish Eapen Jacob, M.D.
• Harmon Voss Jacobs, DDS

• Clinical Social Worker in Arlington, TX
• Providers in Arlington, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.