Individual provider · Type 1 NPI

Lisa Olivia Jackson, LMSW, CASAC

Clinical Social Worker · Bay Shore, NY

NPI number 1902033350 Active

Practice location

1444 5th Avenue, Family Service League
Bay Shore, NY 11706

Call (631) 647-3100 Map

Mailing address

195 Claywood Dr
Brentwood, NY 11717-6809

Specialties and licenses

Taxonomy	Code	License
Addiction (Substance Use Disorder) Counselor	101YA0400X	9582 (NY)
Clinical Social Worker Primary	1041C0700X	076799 (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…

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About NPI 1902033350

Lisa Olivia Jackson, LMSW, CASAC's National Provider Identifier is 1902033350, issued on Jun 12, 2009. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Bay Shore, NY. The record was last updated on Jun 12, 2009.