Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAY BRIAN JACKSON, LCSW
Active Sole ProprietorJAY BRIAN JACKSON, LCSW is a Clinical Social Worker healthcare provider located in RUSSELLVILLE, Missouri. NPI 1730847534 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · RUSSELLVILLE, MO
Registration Details
- NPI Number
- 1730847534
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 30, 2021 (4.6817427629279 yrs)
- Last Updated
- Nov 30, 2021
- License
-
2002031992 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
13722 JEFFERSON RDRUSSELLVILLE, MO, 650742006Browse MO providers · Browse ZIP 65074
- Phone
- 5737820145
- Primary Specialty
-
Clinical Social Worker
1041C0700X
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.