MS. MICHELLE JACKSON (NPI# 1669798112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669798112 |
| Entity Type | Individual |
| Full Name | MS. MICHELLE JACKSON |
| Credential | LCSW |
| Practice Address |
4025 Chestnut St Fl 1 Philadelphia PA 19104-3054 |
| Practice Telephone | 2153826680 |
| Practice Fax Number | 2153861743 |
| Mailing Telephone | 2153826680 |
| Mailing Fax Number | 2153861743 |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2010-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CW016607 | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104434067 | Michelle Jackson | Behavior Technician | 6961 Rooks Ct Apt 305, Frederick, MD 21703-2781 | 2020-07-16 |
| 1790347722 | Michelle Lynn Jackson | Family Medicine | 456 Circle Dr, Kewanee, IL 61443-3622 | 2019-06-29 |
| 1396301487 | Michelle Jackson | Technician | 14000 Castle Blvd Apt 703, Silver Spring, MD 20904-4640 | 2019-05-14 |
| 1184196685 | Michelle Maria Jackson | Health Educator | 220 E 89th St, Brooklyn, NY 11236-1418 | 2018-12-20 |
| 1396253258 | Michelle Laray Jackson | Counselor | 3765 Carisbrook Dr, North Las Vegas, NV 89081-6631 | 2018-01-12 |
| 1427509173 | Michelle Jackson | Behavioral Analyst | 115 Franklin St Ne Apt H21, Washington, DC 20002-1091 | 2016-10-18 |
| 1891193678 | Michelle Jackson | Occupational Therapy Assistant | 12611 Hickman Pl, Denver, CO 80239-6204 | 2014-12-10 |
| 1215338330 | Michelle Jackson | Nurse Practitioner | 115 Fields St # De, Mooresville, IN 46158-1492 | 2014-09-08 |
| 1699058008 | Michelle A Jackson | Occupational Therapist | 6045 Ashford Ln, Unit 102, Naples, FL 34110-2416 | 2011-09-21 |
| 1285923185 | Michelle Ann Jackson | Rehabilitation Practitioner | 7124 Diving Petrels Pl, 7124 Diving Petrels Pl, North Las Vegas, NV 89084-2353 | 2011-03-31 |
| Street Address |
4025 CHESTNUT ST FL 1 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-3054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972712313 | Council for Relationships | Community/Behavioral Health | 4025 Chestnut St Fl 1, Philadelphia, PA 19104-3054 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| 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 |
|---|---|---|---|---|
| 1215538657 | Noel Mitchell | Social Worker | 410 Memphis St, Philadelphia, PA 19125-2642 | 2020-11-03 |
| 1326649963 | Sarah Michelle Waxman | Social Worker | 2550 Grays Ferry Ave, Philadelphia, PA 19146-2331 | 2020-11-02 |
| 1467051540 | Maya Cox | Social Worker | 4045 Green St, Philadelphia, PA 19104-1759 | 2020-10-20 |
| 1679170575 | Wendy Diane Nickerson | Social Worker | 741 S 2nd St, Philadelphia, PA 19147-3425 | 2020-10-04 |
| 1497362404 | Lora M Rhodes | Social Worker | 925 Chestnut St Ste 321a, Philadelphia, PA 19107-4216 | 2020-09-24 |
| 1841806395 | Molly Vocino | Social Worker | 925 Chestnut St Ste 422u, Philadelphia, PA 19107-4216 | 2020-09-21 |
| 1306452065 | Rebecca Cammy | Social Worker | 925 Chestnut St # 422w, Philadelphia, PA 19107-4216 | 2020-09-18 |
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1265045272 | Lisa Gabrielle Schilansky | Social Worker | 4813 Springfield Ave Apt 1, Philadelphia, PA 19143-3409 | 2020-08-28 |
| 1962015537 | Joanna Elizabeth Vanore | Social Worker | 4725 Sheldon St, Philadelphia, PA 19127-1008 | 2020-08-24 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on MS. MICHELLE JACKSON.
| 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.