AMELIA C JACKSON (NPI# 1073878674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073878674 |
| Entity Type | Individual |
| Full Name | AMELIA C JACKSON |
| Other Name | AMELIA C RUSSELL |
| Credential | LMSW |
| Practice Address |
6549 Town Center Dr Suite A Clarkston MI 48346-4824 |
| Practice Telephone | 2486206400 |
| Practice Fax Number | 2486206405 |
| Mailing Telephone | 2486206400 |
| Mailing Fax Number | 2486206405 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2017-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801094446 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134549751 | Amelia Jackson | Adult Companion | 23636 Michigan Ave # 487, Dearborn, MI 48124-1910 | 2014-04-22 |
| 1588094304 | Amelia Jackson | Nurse Practitioner | 7923 Honeygo Blvd, White Marsh, MD 21236 | 2013-11-14 |
| 1558992248 | Amelia Ellen Jackson | Occupational Therapist | 1270 Belmont Ave, Schenectady, NY 12308-2104 | 2020-01-31 |
| 1578017570 | Amelia Jackson | Physical Therapist | 1755 Wittington Pl, #175, Dallas, TX 75234-1927 | 2016-08-08 |
| 1093105918 | Amelia Dee Jackson | Nurse Practitioner | 1101 Jackson St Sw, Gravette, AR 72736-9121 | 2015-01-30 |
| 1801299201 | Amelia Jackson | Registered Nurse | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2014-09-30 |
| Street Address |
6549 TOWN CENTER DR SUITE A |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48346-4824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609882067 | Ismail B. Sendi, Md, PC | Clinic/Center | 6549 Town Center Dr, Suite A, Clarkston, MI 48346-4824 | 2006-07-31 |
| 1235661612 | Aaron Cook | Social Worker | 6549 Town Center Dr, Ste. A, Clarkston, MI 48346-4824 | 2017-04-03 |
| 1104365907 | Renee Somers | Psychologist | 6549 Town Center Dr, Ste. A, Clarkston, MI 48346 | 2017-02-14 |
| 1699126839 | Kathleen Stark | Counselor | 6549 Town Center Dr, Ste. A, Clarkston, MI 48346-4824 | 2016-06-29 |
| 1134579659 | Justine Potthast | Social Worker | 6549 Town Center Dr, Ste. A, Clarkston, MI 48346 | 2016-06-15 |
| 1467813253 | Sara Guzowski | Registered Nurse | 6549 Town Center Dr, Clarkston, MI 48346-4824 | 2016-03-08 |
| 1669831749 | Ann Mills | Registered Nurse | 6549 Town Center Dr, Suite A, Clarkston, MI 48346-4824 | 2016-02-17 |
| 1508234162 | Katherine Krajicek | Nurse Practitioner | 6549 Town Center Dr, Clarkston, MI 48346-4824 | 2015-09-11 |
| 1326434689 | Jason Montgomery | Technician, Other | 6549 Town Center Dr, Clarkston, MI 48346-4824 | 2015-04-13 |
| 1407242761 | Gerald Binford | Technician, Other | 6549 Town Center Dr, Clarkston, MI 48346-4824 | 2015-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399745 | Therapy Services of Clarkston LLC | Clinic/Center | 6770 Dixie Highway, Suite 103, Clarkston, MI 48346 | 2019-10-30 |
| 1679041545 | Shiba Lashon Nixon | Registered Nurse | New Oakland, 6549 Town Center Suite A, Clarkston, MI 48346 | 2018-11-08 |
| 1972079655 | Stephanie Gaumer | Social Worker | 6825 Dixie Hwy Ste E, Clarkston, MI 48346 | 2018-10-19 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1558880591 | 3rd Circle Inc. | Home Health Aide | 39 South Main Street, Ste 2, Clarkston, MI 48346 | 2017-09-11 |
| 1376083246 | Rosemarie Villarreal | Social Worker | 4480 Elmdale Ave, Clarkston, MI 48346 | 2017-02-27 |
| 1932566940 | Syncere Hearts Home Healthcare, LLC | Home Health | 5836 North Marshbank Lane Apt203, Clarkston, MI 48346 | 2016-01-21 |
| 1649635087 | Coddaire & Associates, Inc. | Community/Behavioral Health | 6445 Citation Drive, Suite H, Clarkston, MI 48346 | 2015-12-30 |
| 1013386358 | Victoria Urikh-garcia | Technician, Other | 6510 Town Center Dr Ste E, Clarkston, MI 48346 | 2015-09-16 |
| 1194090993 | Stefanie Pavloski | Counselor | 5701 Bow Pointe Dr., Ste. #380, Clarkston, MI 48346 | 2012-03-13 |
| Find all providers in zip 48346 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611528 | Origins Counseling, Pllc | Social Worker | 8040 Ortonville Rd # E9, Clarkston, MI 48348-4468 | 2020-02-20 |
| 1447880265 | Fieldstone Counseling & Wellness Center | Social Worker | 9191 Dixie Hwy, Clarkston, MI 48348-4248 | 2020-01-21 |
| 1508402934 | Robert Garchow | Social Worker | 3694 Clarkston Rd Ste C, Clarkston, MI 48348-5213 | 2019-11-20 |
| 1366098923 | Holly Jara | Social Worker | 5980 S Main St Ste 101, Clarkston, MI 48346-2377 | 2019-08-09 |
| 1467929471 | Victoria Fleming | Social Worker | 7183 N Main St # 12, Clarkston, MI 48346-1598 | 2018-10-28 |
| 1972079655 | Stephanie Gaumer | Social Worker | 6825 Dixie Hwy Ste E, Clarkston, MI 48346 | 2018-10-19 |
| 1376083246 | Rosemarie Villarreal | Social Worker | 4480 Elmdale Ave, Clarkston, MI 48346 | 2017-02-27 |
| 1629515077 | Laura Munger | Social Worker | 4545 Clawson Tank Dr, Clarkston, MI 48346-2581 | 2017-01-24 |
| 1407206873 | Paul Ulewicz I | Social Worker | 7160 Andersonville Rd, Clarkston, MI 48346-2710 | 2016-06-16 |
| 1598112245 | Kimberly Jill Byrd | Social Worker | 6997 Cranberry Lake Rd, Clarkston, MI 48348-4417 | 2016-05-23 |
| Find all providers in CLARKSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.