Active NPI
Allison Elizabeth Jackson, LCSWA
- Clinical Social Worker
- Wilmington, NC
National Provider Identifier
1982273835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P015196
- Practice address
- 615 Shipyard Blvd
Wilmington, NC 28412-6431 - Phone
- (910) 622-1068
- Fax
- (910) 202-9966
- NPI assigned
- Jun 23, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P015196 | NC | Primary |
Addresses
Primary practice location
615 Shipyard Blvd
Wilmington, NC 28412-6431
Mailing address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Other practice location 1
555 Halyburton Pkwy
Wilmington, NC 28412-3094
Phone (910) 790-9949
Other practice location 2
4005 Oleander Dr
Wilmington, NC 28403-6816
Phone (910) 790-9949
Other practice location 3
1307 Market St
Wilmington, NC 28401-4331
Phone (910) 790-9949
Other practice location 4
2700 N College Rd
Wilmington, NC 28405-8816
Phone (910) 790-9949
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
| License | State | Type | Specialty |
|---|---|---|---|
| P015196 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654041600000",
"number": "1982273835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-622-1068",
"fax_number": "910-202-9966"
}
],
"practiceLocations": [
{
"address_1": "555 Halyburton Pkwy",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284123094",
"country_code": "US",
"telephone_number": "910-790-9949",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4005 Oleander Dr",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284036816",
"country_code": "US",
"telephone_number": "910-790-9949",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1307 Market St",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284014331",
"country_code": "US",
"telephone_number": "910-790-9949",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2700 N College Rd",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284058816",
"country_code": "US",
"telephone_number": "910-790-9949",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "ALLISON",
"middle_name": "ELIZABETH",
"credential": "LCSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-23",
"last_updated": "2022-06-01",
"certification_date": "2022-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P015196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.