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COURTNEY JACKSON LMSW
NPI 1417679473
Social Worker - School in Rochester, NY

Active since September 16, 2022
4115 LAKE AVE, ROCHESTER, NY 14612(585) 324-9273 Get Directions Write a Review

NPPES record last updated: September 16, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Courtney Jackson Lmsw NPPES

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

COURTNEY JACKSON LMSW (NPI 1417679473) is an individual school provider in Rochester, New York, licensed in New York (109152-01) and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1417679473
Entity TypeIndividualFemale
Primary Taxonomy1041S0200X
Provider Legal NameCOURTNEY JACKSONCredential: LMSW
Location Address4115 LAKE AVERochester, NY 14612-4813
Mailing Address211 Collingwood DrRochester, NY 14621-1016 · (585) 472-6253
Phone(585) 324-9273
Sole ProprietorNo
Enumeration DateSeptember 16, 2022
NPPES CertifiedSeptember 16, 2022
✔ NPI 1417679473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial Worker · SchoolBehavioral Health & Social Service Providers
Taxonomy Code1041S0200X
License✔ Licensed in NY · 109152-01
Also ListedSocial WorkerTaxonomy 104100000X · License 109152-01 (NY)
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 109152-01 (NY)
4115 LAKE AVE, Rochester, NY 14612
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Other Names 1

Other Name (5)Mr. Courtney Jackson-troupe Lmsw

Other Providers at the Same Location NPPES 6

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

TOMARA NICOLE MOXLEY LMSW
Social Worker (School)
4115 LAKE AVE
ROCHESTER, NY 14612
Monroe County (585) 760-1032
ASHLEY CALLA MAIN
Social Worker (School)
4115 LAKE AVE
ROCHESTER, NY 14612
Monroe County (585) 623-0517
SHARI M HOGAN NP
Nurse Practitioner (Pediatrics)
4115 LAKE AVE
ROCHESTER, NY 14612
Monroe County (585) 324-7760
ERICA MULLIGAN
Social Worker
4115 LAKE AVE
ROCHESTER, NY 14612
Monroe County (585) 324-9273
MRS. KELLEY F DAVIS LCSW
Social Worker (Clinical)
4115 LAKE AVE
ROCHESTER, NY 14612
Monroe County (585) 663-7070
MRS. BRIDGET C NANNA SLP
Speech-Language Pathologist
4115 LAKE AVE
ROCHESTER, NY 14612
Monroe County (585) 663-7070

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 Courtney Jackson's NPI number?

The NPI number for Courtney Jackson is 1417679473. It was assigned to this individual provider in the NPPES registry on September 16, 2022. The provider is also known as Mr. Courtney Jackson-Troupe Lmsw.

Where is Courtney Jackson located?

Courtney Jackson practices at 4115 Lake Ave, Rochester, NY 14612. The listed phone number is (585) 324-9273.

What is Courtney Jackson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in School, with taxonomy code 1041S0200X.

When was this NPI record last updated?

The NPPES record for Courtney Jackson was last updated on September 16, 2022. 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.