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DERRICK JACK LCSW
NPI 1265096994
Social Worker - Clinical in New Albany, IN

Active since April 29, 2019
2627 CHARLESTOWN RD, NEW ALBANY, IN 47150(812) 944-1550 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 18, 2026, Mar 11, 2026, Apr 29, 2019 (3 updates tracked since 2019).

About Derrick Jack Lcsw NPPES

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

DERRICK JACK LCSW (NPI 1265096994) is an individual clinical provider in New Albany, Indiana, licensed in Indiana (34012719A) and active in the NPI registry since April 2019. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1265096994
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameDERRICK JACKCredential: LCSW
Location Address2627 CHARLESTOWN RDNew Albany, IN 47150-2536
Mailing Address1400 Main St. Ste 196Clarksville, IN 47129-3121 · (502) 269-4066
Phone(812) 944-1550
Sole ProprietorNo
Enumeration DateApril 29, 2019
Last NPPES UpdateMay 18, 20263 updates tracked since enumeration
NPPES CertifiedMay 18, 2026
✔ NPI 1265096994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IN · 34012719A
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.
2627 CHARLESTOWN RD, New Albany, IN 47150
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Secondary Practice Locations 2

Location 1425 Watt StJeffersonville, IN 47130-3957 · Phone (812) 944-1550
Location 21400 Main St. Ste 196Clarksville, IN 47129 · Phone (502) 269-4066

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.

EMILY SPURGEON LMHCA
Psychologist (Counseling)
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (812) 944-1550
MISS KAREN CHINWE IDIGO M.S.
Counselor (Mental Health)
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (812) 944-1550
DAWN GORE MEADOR
Psychologist (School)
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (463) 900-8396
ASSOCIATES IN COUNSELING AND PSYCHTHERAPY
Community/Behavioral Health
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (812) 944-1550
DENISE SCRIVNER M.S.
Counselor (Mental Health)
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (812) 944-1550
AMY LOUISE OGDEN
Counselor (Mental Health)
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (812) 944-1550
LUCAS HUCKABY
Counselor (Mental Health)
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (812) 944-1550
BRITTANY JONES
Counselor (Mental Health)
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150
Floyd County (812) 944-1550

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 Derrick Jack's NPI number?

The NPI number for Derrick Jack is 1265096994. It was assigned to this individual provider in the NPPES registry on April 29, 2019.

Where is Derrick Jack located?

Derrick Jack practices at 2627 Charlestown Rd, New Albany, IN 47150. The listed phone number is (812) 944-1550.

What is Derrick Jack'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 Derrick Jack was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.