Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DERIC R JACKSON, LICSW
ActiveMR. DERIC R JACKSON, LICSW is a Clinical Social Worker healthcare provider located in HASTINGS, Minnesota. NPI 1093423337 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · HASTINGS, MN
Registration Details
- NPI Number
- 1093423337
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 7, 2022 (3.7727604108565 yrs)
- Last Updated
- Nov 28, 2022
- License
-
21544 (MN)
Practice Information
- Address
-
1320 S FRONTAGE RD STE 200HASTINGS, MN, 550332481Browse MN providers · Browse ZIP 55033
- Phone
- 6515000905
- Primary Specialty
-
Clinical Social Worker
1041C0700X
Other Clinical Social Worker Providers in HASTINGS, MN
| Name | Credential | NPI |
|---|---|---|
| MS. PATRICIA DOROTHY GOSZ | LICSW | 1093862518 |
| JANE VICTORIA SCHWARK | MSW, LICSW | 1023309895 |
| MICHAELA J. BURR | LICSW | 1427472810 |
| JENNA TRISCARI | MSW, LICSW | 1063925584 |
| TERRA LARAE PINGLEY | MSW, LGSW | 1467017145 |
| AARON JOSHUA KENNELL | LGSW | 1649902685 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.