Individual provider · Type 1 NPI
Roberta Marie Jackson, LCSW CASAC-II
Clinical Social Worker · New York, NY
Practice location
105 W 125th St, Front 1 #1042
New York, NY 10027-4444
Fax (646) 759-4019
Mailing address
105 West 125th St, Front 1 #1042
New York, NY 10027-4444
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 35723 (NY) |
| Clinical Social Worker Primary | 1041C0700X | 088300-01 (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…
2 other providers at this address
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About NPI 1760013353
Roberta Marie Jackson, LCSW CASAC-II's National Provider Identifier is 1760013353, issued on Jan 31, 2020. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in New York, NY. The record was last updated on Aug 30, 2024.