JATAYVIA JAQAE JACKSON LLMSW
NPI 1174012389
Social Worker - Clinical in Saginaw, MI

Q: What is Jatayvia Jackson's NPI number?

The NPI number for Jatayvia Jackson is 1174012389. It was assigned to this individual provider in the NPPES registry on May 2, 2018. The provider is also known as Jatayvia Jaqae Waller.

Q: What is Jatayvia Jackson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jatayvia Jackson was last updated on April 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 02, 2018

3253 CONGRESS AVE, SAGINAW, MI 48602(989) 475-4171(989) 393-6021 Get Directions Write a Review

NPPES record last updated: April 8, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 8, 2023, May 2, 2018 (2 updates tracked since 2018).

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About Jatayvia Jaqae Jackson Llmsw NPPES

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

JATAYVIA JAQAE JACKSON LLMSW (NPI 1174012389) is an individual clinical provider in Saginaw, Michigan, licensed in Michigan (6851115529) and active in the NPI registry since May 2018. She maintains a secondary practice location in Bingham Farms.

NPPES Registry Identity

NPI1174012389

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameJATAYVIA JAQAE JACKSONCredential: LLMSW

Location Address3253 CONGRESS AVESaginaw, MI 48602-3106

Mailing Address32100 Telegraph Rd Ste 205Bingham Farms, MI 48025-2454 · (248) 712-4266

Phone(989) 475-4171

Fax(989) 393-6021

Sole ProprietorNo

Enumeration DateMay 2, 2018

Last NPPES UpdateApril 8, 20232 updates tracked since enumeration

NPPES CertifiedApril 8, 2023

✔ NPI 1174012389 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 MI · 6851115529

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 ListedTechnician/TechnologistTaxonomy 156F00000X

3253 CONGRESS AVE, Saginaw, MI 48602

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Other Names 1

Former Name (1)Jatayvia Jaqae Waller

Secondary Practice Location 1

Location 132100 Telegraph Rd Ste 205Bingham Farms, MI 48025-2454 · Phone (248) 712-4266

Other Providers at the Same Location NPPES 20

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

LOREAL HARTWELL LLMSW

Social Worker (Clinical)