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CHARLES BARTLETT JACKSON JR.
NPI 1003149048
Social Worker - Clinical in Roxboro, NC

Active since September 09, 2009
355 S MADISON BLVD STE C1, ROXBORO, NC 27573(336) 599-8366(336) 322-6168 Get Directions Write a Review

NPPES record last updated: September 6, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Charles Bartlett Jackson Jr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES BARTLETT JACKSON JR. (NPI 1003149048) is an individual clinical provider in Roxboro, North Carolina, licensed in North Carolina (C007168) and active in the NPI registry since September 2009.

NPPES Registry Identity

NPI1003149048
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameCHARLES BARTLETT JACKSON JR.
Location Address355 S MADISON BLVD STE C1Roxboro, NC 27573-5485
Mailing Address355 S Madison Blvd Ste C1Roxboro, NC 27573-5485 · (336) 599-8366 · Fax (336) 322-6168
Phone(336) 599-8366
Fax(336) 322-6168
Sole ProprietorNo
Enumeration DateSeptember 9, 2009
Last NPPES UpdateSeptember 6, 2015
✔ NPI 1003149048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NC · C007168
Definition
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.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 1513 (NC)
355 S MADISON BLVD STE C1, Roxboro, NC 27573
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Other Identifiers 2

Medicare PINQ37125ANC
Medicaid6112139NC

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHY LYNN MEDLIN LMFTA
Marriage & Family Therapist
355 S MADISON BLVD STE C1
ROXBORO, NC 27573
Person County (833) 800-1505

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Jackson's NPI number?

The NPI number for Charles Jackson is 1003149048. It was assigned to this individual provider in the NPPES registry on September 9, 2009.

Where is Charles Jackson located?

Charles Jackson practices at 355 S Madison Blvd Ste C1, Roxboro, NC 27573. The listed phone number is (336) 599-8366.

What is Charles Jackson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Charles Jackson was last updated on September 6, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.