Individual provider · Type 1 NPI

Michelle Marie Jack, LCSW

Clinical Social Worker · San Diego, CA

NPI number 1386043503 Active

Practice location

409 Camino Del Rio S Ste 201
San Diego, CA 92108-3505

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	LCSW96801 (CA)
Mental Health Counselor	101YM0800X	None listed

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 1386043503

Michelle Marie Jack, LCSW's National Provider Identifier is 1386043503, issued on Aug 14, 2014. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in San Diego, CA. The record was last updated on Feb 17, 2022.