MRS. SANDRA LYDIA JACKSON (NPI# 1467767319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467767319 |
| Entity Type | Individual |
| Full Name | MRS. SANDRA LYDIA JACKSON |
| Credential | LICSW, LCSW-C |
| Practice Address |
3102 Floral Park Rd Clinton MD 20735-9665 |
| Mailing Address |
8406 Owens Way Brandywine MD 20613-5715 |
| Practice Telephone | 3012922778 |
| Practice Fax Number | 3012920275 |
| Mailing Telephone | 3017824551 |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2010-08-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
LC302754 | DC | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
09990 | MD | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316408792 | Sandra Rae Jackson | Occupational Therapy Assistant | 6308 Parkwood Pl, Amarillo, TX 79119-5003 | 2019-03-27 |
| 1124449053 | Sandra J Jackson | Counselor | 4218 Western Ave., South Bend, IN 46619 | 2013-12-19 |
| 1710230917 | Sandra Evans Jackson | Counselor | 1035 Director Ct, Suite C, Greenville, NC 27858-5996 | 2012-10-25 |
| 1407170665 | Sandra Marie Jackson | Marriage & Family Therapist | 6809 Indiana Ave Ste B8, Riverside, CA 92506 | 2010-03-17 |
| 1619118288 | Sandra Denise Jackson | Durable Medical Equipment & Medical Supplies | 4303 Herridge St, Houston, TX 77022-3944 | 2009-03-11 |
| 1740425735 | Sandra Renee Jackson | Physical Therapist | 4476 Winding Creek Rd, Manlius, NY 13104-2482 | 2008-12-05 |
| 1255535860 | Sandra Denise Jackson | Licensed Vocational Nurse | 708 Bond St, Copperas Cove, TX 76522-3079 | 2007-06-14 |
| 1316089840 | Sandra Gordon Jackson | Social Worker | 2121 Sage Rd Ste 180, Houston, TX 77056-4326 | 2007-02-12 |
| 1326195959 | Sandra Jackson | Social Worker | 2750 N Lakeview Dr, Warsaw, IN 46582-8408 | 2007-01-04 |
| 1366459778 | Sandra G. Jackson | Counselor | 1900 E. Tenth Street, Alamogordo, NM 88310 | 2006-08-01 |
| Street Address |
3102 FLORAL PARK RD |
| City | CLINTON |
| State | MD |
| Zip Code | 20735-9665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447274139 | Mary Ann D. Morgan | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2006-07-26 |
| 1992337018 | Peter Jonathan Buckingham | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2020-02-06 |
| 1215417209 | Karen Haaland Hubbard | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2018-08-18 |
| 1699254011 | Renee Williams | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2018-08-07 |
| 1427460559 | Donna Melynda Hutt-clarke | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2014-05-23 |
| 1336489129 | Jacqueline Evelyn Wenger | Social Worker | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2013-02-15 |
| 1083903116 | Julie Kuhns | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2011-03-29 |
| 1710280912 | Lisa Connors | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2010-12-09 |
| 1710294780 | Hiram Jennings | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2010-09-10 |
| 1699095158 | Thomas Gillespie Smith | Counselor | 3102 Floral Park Rd, Clinton, MD 20735-9665 | 2010-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659985455 | Lisa C Frasca | Social Worker | 1802 State Route 31 Ste 233, Clinton, NJ 08809-2033 | 2020-08-31 |
| 1245855972 | Joshua D. Burgess Lcsw | Social Worker | 63 Norton Ave, Clinton, NY 13323-1321 | 2020-06-09 |
| 1588284210 | Kimberly Wheaton Middleton | Social Worker | 552 Springridge Rd Apt C5, Clinton, MS 39056-5631 | 2020-04-22 |
| 1073161204 | Guiding Light Counseling, LLC | Social Worker | 110 Cow Hill Rd, Clinton, CT 06413-1341 | 2019-08-30 |
| 1679130561 | Joseph Patrick Lamb | Social Worker | 2419 W 1850 N, Clinton, UT 84015-5709 | 2019-05-25 |
| 1538620828 | Rachel H Daniels | Social Worker | 1311 Reserve Dr, Clinton, MS 39056-5658 | 2019-03-28 |
| 1629535166 | Tarsha Harris Moore | Social Worker | 8102 Hunters Green Ct, Clinton, MD 20735-2989 | 2019-02-20 |
| 1174090120 | Shifting Your Gears, LLC | Social Worker | 1802 State Route 31, Clinton, NJ 08809-2033 | 2018-10-29 |
| 1285122432 | Jean M Baker | Social Worker | 3 Fountain St Ste 201, Clinton, NY 13323-1747 | 2018-04-24 |
| 1619490851 | Kristyn Wagner | Social Worker | 90 N 31st Street, Clinton, OK 73601 | 2017-07-19 |
| Find all providers in CLINTON | ||||
Please comment or provide details below to improve the information on MRS. SANDRA LYDIA JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.