KELLY JACKSON
NPI 1407522428
Social Worker - Clinical in Cedar Lake, IN

Active since August 19, 2021
11631 CEDAR ST, CEDAR LAKE, IN 46303(219) 682-8211 Get Directions Write a Review

NPPES record last updated: August 19, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Jackson NPPES

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

KELLY JACKSON (NPI 1407522428) is an individual clinical provider in Cedar Lake, Indiana, licensed in Indiana (34006136A) and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1407522428
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY JACKSON
Location Address11631 CEDAR STCedar Lake, IN 46303-7290
Mailing Address11631 Cedar Street, Cedar Lake, In 46303East Cedar Lake, IN 46303 · (219) 682-8211
Sole ProprietorNo
Enumeration DateAugust 19, 2021
NPPES CertifiedJuly 29, 2021
NPI 1407522428 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 · 34006136A
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.
11631 CEDAR ST, Cedar Lake, IN 46303

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 Kelly Jackson's NPI number?

The NPI number for Kelly Jackson is 1407522428. It was assigned to this individual provider in the NPPES registry on August 19, 2021.

Where is Kelly Jackson located?

Kelly Jackson practices at 11631 Cedar St, Cedar Lake, IN 46303. The listed phone number is (219) 682-8211.

What is Kelly 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 Kelly Jackson was last updated on August 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.