MS. DEBORAH LEE JACKSON LCSW NPI 1003006842

Social Worker (Clinical) in Chicago, IL

About DEBORAH JACKSON

Deborah Jackson is a provider in Chicago, IL. The NPI number assigned to this provider is 1003006842. The practitioner's primary taxonomy code is Social Worker (1041C0700X). The provider is registered as an individual and their NPI record was last updated 10 years ago.

NPI1003006842 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameMS. DEBORAH LEE JACKSON LCSW
Provider Location Address2820 W PETERSON AVE CHICAGO, IL 60659 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address2820 W. PETERSON AVE CHICAGO, IL 60659 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date07-27-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-27-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

MS. DEBORAH LEE JACKSON LCSW
2820 W PETERSON AVE
CHICAGO, IL
ZIP 60659
Phone: (773) 293-8437
Fax: (773) 728-4751
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Mailing Address

MS. DEBORAH LEE JACKSON LCSW
2820 W. PETERSON AVE
CHICAGO, IL
ZIP 60659
Phone: (773) 293-8437
Fax: (773) 728-4751

Primary Taxonomy

Taxonomy Code1041C0700X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationSocial Worker
TypeBehavioral Health & Social Service Providers
SpecializationClinical
License StateIL
Taxonomy DescriptionA 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.

Map Location


MS. DEBORAH LEE JACKSON LCSW address is 2820 W PETERSON AVE CHICAGO, IL 60659

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023272903 FALGUNI AMIN M.ED, LCPC
Individual
Counselor (Professional)2820 W PETERSON AVE
CHICAGO, IL 60659
(773) 761-0300
1659449106DR. SOMBOON SRIAROON M.D.
Individual
Obstetrics & Gynecology (Obstetrics)2820 W PETERSON AVE
CHICAGO, IL 60659
(773) 761-0300