Individual provider · Type 1 NPI

Carroll S. Jackson, L.I.S.W.

Clinical Social Worker · Dayton, OH

NPI number 1184097842 Active

Practice location

4130 Linden Ave, Suite 250
Dayton, OH 45432-3015

Call (937) 681-9644 Map

Mailing address

6504 Semmes Ln
Dayton, OH 45424-7117

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XI.0009433 (OH)

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 1184097842

Carroll S. Jackson, L.I.S.W.'s National Provider Identifier is 1184097842, issued on Nov 3, 2015. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Dayton, OH. The record was last updated on Dec 11, 2015.