Individual provider · Type 1 NPI

Maia Shanae Jackson, LICSW

Clinical Social Worker · Minneapolis, MN

NPI number 1194311043 Active

Practice location

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Call (612) 871-1454 Map

Fax (612) 871-1505

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Clinical Social Worker Primary 1041C0700X29112 (MN)

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 1194311043

Maia Shanae Jackson, LICSW's National Provider Identifier is 1194311043, issued on Dec 15, 2020. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Minneapolis, MN. The record was last updated on Oct 13, 2022.