DR. MARY SEBRENA JACKSON (NPI# 1700186707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700186707 |
| Entity Type | Individual |
| Full Name | DR. MARY SEBRENA JACKSON |
| Credential | LCSW |
| Practice Address |
450 Racetrack Rd Mcdonough GA 30252-6837 |
| Mailing Address |
Po Box 123 Mcdonough GA 30253-0123 |
| Practice Telephone | 7703059881 |
| Practice Fax Number | 6785654626 |
| Mailing Telephone | 7703059881 |
| Mailing Fax Number | 6785654626 |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CSW004250 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605690 | Mary Sonya Jackson | Contractor | 5480 Hedge Brooke Pointe Nw, Acworth, GA 30101-7142 | 2020-10-06 |
| 1194388678 | Mary Sheree Jackson | Home Health Aide | 226 Mckinley St, Pittsburgh, PA 15210-3312 | 2019-04-19 |
| 1508358813 | Mary Jackson | Counselor | 3442 W Emma Pl, Queen Creek, AZ 85142-0506 | 2018-06-01 |
| 1891220935 | Mary Jackson | Counselor | 2824 N Cascade Ave, Colorado Springs, CO 80907-6213 | 2017-04-26 |
| 1992152672 | Mary Jackson | Non-emergency Medical Transport (VAN) | 421 Lively Hope Rd, Callao, VA 22435-2511 | 2016-05-23 |
| 1699121129 | Mary Theresa Jackson | Counselor | 345 Old Cuyler Rd, Ellabell, GA 31308-5858 | 2016-05-13 |
| 1013331586 | Mary Jackson I | Chore Provider | 555 Old Lewiston Rd, Winthrop, ME 04364-4112 | 2014-02-04 |
| 1316203854 | Mary Louise Jackson | Home Health Aide | 256 Clairmont Ave, Mansfield, OH 44903-1547 | 2012-04-10 |
| 1376835298 | Mary Bickel Jackson | Nutritionist | 33 Fulton Plaza, Middletown, NY 10940 | 2011-05-11 |
| 1437456522 | Mary Elisabeth Jackson | Counselor | 804 South Oakland Ave, Carbondale, IN 62901 | 2011-02-25 |
| Street Address |
450 RACETRACK RD |
| City | MCDONOUGH |
| State | GA |
| Zip Code | 30252-6837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891096038 | Apple Educational and Counseling Services, LLC | Community/Behavioral Health | 450 Racetrack Rd, Mcdonough, GA 30252-6837 | 2010-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114427 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 3479 Highway 81 East, Mcdonough, GA 30252 | 2020-11-03 |
| 1770143547 | Kevin Kirk Anderson | Physical Therapist | Dr. Kevin Anderson, 196 Lake Dow Rd, Mcdonough, GA 30252 | 2019-06-14 |
| 1912474537 | Atlanta Neuromonitoring, LLC | Psychiatry & Neurology | 922 Highway 81 East # 242, Mcdonough, GA 30252 | 2018-11-01 |
| 1194271320 | Christine Williams Breeden | Registered Nurse | 189 Irwin Drive, Mcdonough, GA 30252 | 2016-08-28 |
| 1518322395 | Jaquita Shorts | Counselor | 1705 Pennslyvania Ave, Mcdonough, GA 30252 | 2015-12-22 |
| 1356758973 | Keisha Candies | Counselor | 125 Zack Hinton Pkwy, Mcdonough, GA 30252 | 2014-07-15 |
| 1093145666 | Ceisha Shador Parks | Counselor | 6040 Winston Trace, Mcdonough, GA 30252 | 2013-11-19 |
| 1588939565 | Tasha E Jones | Counselor | 1509 Bent River Cir, Mcdonough, GA 30252 | 2012-03-09 |
| 1598049447 | Proactive Rehab, Inc | Physical Therapist | 50 Lawrenceville Street, Suite 100, Mcdonough, GA 30252 | 2011-10-10 |
| 1164706131 | Michelle Lee Cone | Pharmacist | 1210 Bent Creek Dr, Mcdonough, GA 30252 | 2011-10-07 |
| Find all providers in zip 30252 | ||||
| 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 |
|---|---|---|---|---|
| 1831706662 | Denitra Miller | Social Worker | 405 Canoga Ct, Mcdonough, GA 30253-8670 | 2020-09-25 |
| 1417595992 | Courtney Faith Farley-white | Social Worker | 265 Cobblestone Ln, Mcdonough, GA 30252-6259 | 2019-12-16 |
| 1326501776 | David Eric Robertson | Social Worker | 7041 Regency Ln, Mcdonough, GA 30253-8650 | 2019-04-12 |
| 1770059495 | Amy Slone Ripley | Social Worker | 1705 Pennsylvania Ave, Mcdonough, GA 30253-9118 | 2018-10-19 |
| 1851806566 | Aspirational Visions for Traumatic Events | Social Worker | 553 Tulip Ln, Mcdonough, GA 30252-1039 | 2017-12-05 |
| 1942730965 | Echoes of Harmony Counseling Services, LLC | Social Worker | 903 Pavilion Ct Ste R, Mcdonough, GA 30253-5224 | 2017-06-13 |
| 1699212910 | Tammy Austin | Social Worker | 317 Whitney Ln, Mcdonough, GA 30253-7767 | 2017-01-24 |
| 1710353156 | Sally H Clanin, Lcsw, LLC | Social Worker | 922 Highway 81 E, Ste 151, Mcdonough, GA 30252-2978 | 2015-08-20 |
| 1043690688 | Rozalind Williams-heath | Social Worker | 1208 Mandalay Pkwy, Mcdonough, GA 30253-6117 | 2015-06-08 |
| 1730585464 | Candice Gould | Social Worker | 1244 Polk Xing, Mcdonough, GA 30252-8081 | 2014-11-06 |
| Find all providers in MCDONOUGH | ||||
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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.