Individual provider · Type 1 NPI

Kelly Jackson

Clinical Social Worker · Cedar Lake, IN

NPI number 1407522428 Active

Practice location

11631 Cedar St
Cedar Lake, IN 46303-7290

Mailing address

11631 Cedar Street, Cedar Lake, In 46303
East Cedar Lake, IN 46303

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X34006136A (IN)

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 1407522428

Kelly Jackson's National Provider Identifier is 1407522428, issued on Aug 19, 2021. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Cedar Lake, IN. The record was last updated on Aug 19, 2021.