DERRICK JACK LCSW
NPI 1265096994
Social Worker - Clinical in New Albany, IN
NPI Status: Active since April 29, 2019
Contact Information
2627 CHARLESTOWN RD
NEW ALBANY, IN
ZIP 47150
Phone: (812) 944-1550
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Individual
- Male
- Social Worker
- Clinical
About DERRICK JACK
This page provides the complete NPI Profile along with additional information for Derrick Jack, a provider established in New Albany, Indiana with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1265096994 assigned on April 2019. The practitioner's primary taxonomy code is 1041C0700X with license number 34012719A (IN). The provider is registered as an individual and his NPI record was last updated May 2026.
- NPI
- 1265096994
- Provider Name
- DERRICK JACK LCSW
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2627 CHARLESTOWN RD NEW ALBANY, IN 47150
- Location Phone
- (812) 944-1550
- Mailing Address
- 1400 MAIN ST. STE 196 CLARKSVILLE, IN 47129
- Mailing Phone
- (502) 269-4066
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-29-2019
- Last Update Date
- 05-18-2026
- Code Navigator
A clinical social worker like Derrick Jack is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
Location Map
Secondary Locations
- 1400 Main St. Ste 196
Clarksville, IN 47129
(502) 269-4066 - 425 Watt St
Jeffersonville, IN 47130
(812) 944-1550
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 34012719A
- License State
- IN
- Taxonomy Description
- 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1265096994, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
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NEW ALBANY, IN 47150
NEW ALBANY, IN 47150
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265096994, enumerated as an "individual" on April 29, 2019.
The provider is located at 2627 CHARLESTOWN RD NEW ALBANY, IN 47150 and the phone number is (812) 944-1550.
Social Worker with taxonomy code 1041C0700X and a focus in Clinical.
