Adrienne Michelle Jackson, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16273 Issued in SC

Practice address

29 Flint Way
Blythewood, SC 29016-5827

Phone

(803) 920-3946

NPI assigned

Jan 12, 2022

Sex

Female

Sole proprietor

No

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 SC, ME, WV3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Warm Embrace Counseling Services, LLC

  • Clinical Social Worker
  • Blythewood, SC
  • NPI 1457137283
  Medicare reassignment NPD Authorized official
• Talkspace Provider Network PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1639814049

  ME, SC, WV

  Medicare reassignment NPD
• Manely Hope and Healing, PLLC

  • Adult Mental Health Clinic/Center
  • Morrill, ME
  • NPI 1942092465
  NPD (past)

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1992456784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 FLINT WAY",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290165827",
            "telephone_number": "803-920-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 FLINT WAY",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290165827",
            "telephone_number": "803-920-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ADRIENNE",
        "middle_name": "MICHELLE",
        "credential": "LISW-CP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "16273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Huey, OT
• Gene F Huguenin
• Virginia McCorkle Hutto, LISW-CP
• Nina Hyvarinen Jones, DDS
• Ja Transport
• Norward Earl Jackson
• Terronda Lanae Jackson, MA, LPCA
• John C Cosby Jr DMD PA
• Calvin D Johnson Jr., LCMT
• Miyuki Maureen Johnson

• Clinical Social Worker in Blythewood, SC
• Providers in Blythewood, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.