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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KELLY JACKSON

Active

KELLY JACKSON is a Clinical Social Worker healthcare provider located in CEDAR LAKE, Indiana. NPI 1407522428 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · CEDAR LAKE, IN

Registration Details

NPI Number
1407522428
Provider Type
Individual
Gender
Female
NPI Issued
Aug 19, 2021 (4.9666186699159 yrs)
Last Updated
Aug 19, 2021
License
34006136A (IN)

Practice Information

Address
11631 CEDAR ST
CEDAR LAKE, IN, 463037290
Browse IN providers · Browse ZIP 46303
Phone
2196828211
Primary Specialty
Clinical Social Worker
1041C0700X

Other Clinical Social Worker Providers in CEDAR LAKE, IN

Name Credential NPI
TERRY HARMAN LCSW 1568687937
MRS. TRACI L NOBLE MSW, LCSW 1184840852
MARGARET PARKER LCSW 1962811844
DR. KRISTIN ANN HUSEMAN DSW LCSW 1760170633
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.