Individual provider · Type 1 NPI

Laurie Ann Jackson, LCSW R

Clinical Social Worker · Rego Park, NY

NPI number 1104907187 Active

Practice location

9745 Queens Blvd Ph Floor
Rego Park, NY 11374-2101

Fax (718) 830-0724

Mailing address

16832 127th Ave Apt 6
Jamaica, NY 11434-3156

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XR056949-1 (NY)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104907187

Laurie Ann Jackson, LCSW R's National Provider Identifier is 1104907187, issued on Oct 18, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Rego Park, NY. The record was last updated on Jul 9, 2007.