Active NPI
Bambi Jackson, MSW
- Clinical Social Worker
- Duluth, GA
National Provider Identifier
1912474685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 8304 Woodiron Dr
Duluth, GA 30097-3755 - Phone
- (770) 299-9752
- NPI assigned
- Oct 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
8304 Woodiron Dr
Duluth, GA 30097-3755
Mailing address
8304 Woodiron Dr
Duluth, GA 30097-3755
Phone (770) 299-9752
Other practice location 1
700 Massachusetts Avenue, 3rd Floor
Cambridge, MA 02139
Phone (888) 500-2067
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749427200000",
"number": "1912474685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8304 WOODIRON DR",
"city": "DULUTH",
"state": "GA",
"postal_code": "300973755",
"telephone_number": "770-299-9752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8304 WOODIRON DR",
"city": "DULUTH",
"state": "GA",
"postal_code": "300973755",
"telephone_number": "770-299-9752"
}
],
"practiceLocations": [
{
"address_1": "700 Massachusetts Avenue, 3rd Floor",
"address_purpose": "LOCATION",
"city": "Cambridge",
"state": "MA",
"postal_code": "02139",
"country_code": "US",
"telephone_number": "888-500-2067",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "BAMBI",
"name_prefix": "Miss",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-30",
"last_updated": "2025-06-09",
"certification_date": "2025-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.