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MISS LISA OLIVIA JACKSON LMSW, CASAC
NPI 1902033350
Social Worker - Clinical in Bay Shore, NY

Active since June 12, 2009
1444 5TH AVENUE, FAMILY SERVICE LEAGUE, BAY SHORE, NY 11706(631) 647-3100 Get Directions Write a Review

NPPES record last updated: June 12, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Miss Lisa Olivia Jackson Lmsw, Casac NPPES

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

MISS LISA OLIVIA JACKSON LMSW, CASAC (NPI 1902033350) is an individual clinical provider in Bay Shore, New York, licensed in New York (076799) and active in the NPI registry since June 2009.

NPPES Registry Identity

NPI1902033350
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMISS LISA OLIVIA JACKSONCredential: LMSW, CASAC
Location Address1444 5TH AVENUE, FAMILY SERVICE LEAGUEBay Shore, NY 11706
Mailing Address195 Claywood DrBrentwood, NY 11717-6809 · (631) 334-1761
Phone(631) 647-3100
Sole ProprietorYes
Enumeration DateJune 12, 2009
✔ NPI 1902033350 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 NY · 076799
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 ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 9582 (NY)
1444 5TH AVENUE, Bay Shore, NY 11706
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Other Providers at the Same Location NPPES 3

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

SANDRA RIVERA LCSW
Social Worker (Clinical)
1444 5TH AVENUE
BAYSHORE, NY 11706
Suffolk County (631) 647-3700
MS. BRIDGET VAHER LMSW
Social Worker
1444 5TH AVENUE
BAY SHORE, NY 11706
Suffolk County (631) 650-0115
JEANNINE MARIE RIZZO LCSW-R
Social Worker
1444 5TH AVENUE
BAYSHORE, NY 11706
Suffolk County (631) 647-3100

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 Lisa Jackson's NPI number?

The NPI number for Lisa Jackson is 1902033350. It was assigned to this individual provider in the NPPES registry on June 12, 2009.

Where is Lisa Jackson located?

Lisa Jackson practices at 1444 5th Avenue Family Service League, Bay Shore, NY 11706. The listed phone number is (631) 647-3100.

What is Lisa 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 Lisa Jackson was last updated on June 12, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.