Individual provider Active NPI

Nikiya Ford-Jackson, LMSW, LGSW, LICSW,

  • Social Worker
  • Upper Marlboro, MD
National Provider Identifier
1881152981
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LC50082168 Issued in DC
Practice address
10511 Brightfield LN
Upper Marlboro, MD 20772-2417
Phone
(301) 221-9549
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21607 MD
Social Worker 104100000X LC50082168 DC Primary

Addresses

Primary practice location

10511 Brightfield LN
Upper Marlboro, MD 20772-2417

Mailing address

10511 Brightfield LN
Upper Marlboro, MD 20772-2417
Phone (301) 221-9549

Other practice location 1

6188 Oxon Hill Rd
Oxon Hill, MD 20745-3113
Phone (301) 567-0400

Other practice location 2

1628 Good Hope Rd SE
Washington, DC 20020-4706
Phone (202) 866-7505

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
LC50082168DCMDSocial Worker
21607MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
One Care DC Inc PastSince Dec 1, 2018 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1881152981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10511 BRIGHTFIELD LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722417",
            "telephone_number": "301-221-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10511 BRIGHTFIELD LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722417",
            "telephone_number": "301-221-9549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6188 Oxon Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Oxon Hill",
            "state": "MD",
            "postal_code": "207453113",
            "country_code": "US",
            "telephone_number": "301-567-0400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1628 Good Hope Rd SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200204706",
            "country_code": "US",
            "telephone_number": "202-866-7505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD-JACKSON",
        "first_name": "NIKIYA",
        "credential": "LMSW, LGSW, LICSW,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21607",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LC50082168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.