MR. RICHARD ALLEN JACKSON (NPI# 1629520770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629520770 |
| Entity Type | Individual |
| Full Name | MR. RICHARD ALLEN JACKSON |
| Credential | LICSW |
| Practice Address |
201 W Laurel St Brainerd MN 56401-3902 |
| Mailing Address |
823 Maple St Brainerd MN 56401-3770 |
| Practice Telephone | 2184543844 |
| Practice Fax Number | 2184543844 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2018-04-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
23282 | MN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 201 W Laurel St, Brainerd, MN 564013902 | 2184543844 | 2184543844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386924363 | Richard Ray Jackson | Social Worker | 104 S Ridge Ave, Troy, OH 45373-2704 | 2011-08-23 |
| 1124240197 | Richard Jackson | Psychologist | 2650 West 2700 South, Syracuse, UT 84075 | 2007-05-02 |
| 1508081993 | Richard Jackson | Psychiatry & Neurology | E 4111 Andover Road Suite 220, Bloomfield Hills, MI 48302 | 2007-04-13 |
| 1851478101 | Richard Jackson | Pharmacist | 420 Delaware St Se # Mmc812, Minneapolis, MN 55455-0341 | 2006-11-01 |
| 1972616134 | Richard Pharus Jackson | Optometrist | 216 W Washington St, Anthony, TX 79821-9304 | 2006-08-15 |
| 1801810163 | Richard Edwin Jackson | Dentist | 109 Timbermill Dr, Lexington, SC 29073-7138 | 2006-07-27 |
| 1366483406 | Richard D Jackson | Family Medicine | 29 Eastbrook Rd, Ronks, PA 17572-9769 | 2006-06-09 |
| 1659328060 | Richard Jackson | Emergency Medicine | 505 Regency Xing, Southlake, TX 76092-9501 | 2006-05-30 |
| 1174587505 | Richard E Jackson | Physician Assistant | 21260 Olean Blvd Ste 200, Port Charlotte, FL 33952-6742 | 2006-04-13 |
| 1629046339 | Richard K Jackson | Dentist | 1975 Sansburys Way Ste 112, West Palm Beach, FL 33411-1928 | 2006-03-09 |
| Street Address |
201 W LAUREL ST |
| City | BRAINERD |
| State | MN |
| Zip Code | 56401-3902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225520851 | Nicole Ann Rieke | Social Worker | 201 W Laurel St, Brainerd, MN 56401-3902 | 2018-05-30 |
| 1669991071 | Melissa Lee Stave | Counselor | 201 W Laurel St, Brainerd, MN 56401-3902 | 2017-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396222832 | Nicholas James Manning | Physical Therapist | 7350 Clearwater Rd N, Baxter, MN 56401 | 2018-07-27 |
| 1952819757 | Hannah Marie Darabi | Physical Therapist | Essentia Health Rehabilitation Services, 2016 South Sixth Street, Brainer, MN 56401 | 2018-01-15 |
| 1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1245638584 | The Renneke Chiropractic Clinic | Physical Therapist | 623 Madison St., Brainerd, MN 56401 | 2014-12-19 |
| 1124420179 | Jenna Niggeler | Acupuncturist | 1001 Kingwood St Ste 119a, Brainerd, MN 56401 | 2014-09-22 |
| 1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
| 1073864666 | Jennifer L. Owens | Marriage & Family Therapist | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2012-09-24 |
| 1619297447 | Christine Elaine Smalling | Licensed Practical Nurse | 6317 Estate Circle Drive, Brainerd, MN 56401 | 2010-06-03 |
| 1528241577 | Dannia Lor Vang | Pharmacist | 2024 South 6th St, Clinic Pharmacy, Brainerd, MN 56401 | 2007-12-13 |
| Find all providers in zip 56401 | ||||
| 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 |
|---|---|---|---|---|
| 1609306489 | Maria Danielle Holm | Social Worker | 8058 Lucky Ln, Brainerd, MN 56401-1609 | 2017-06-14 |
| 1467984484 | Wendy Ruth Olson | Social Worker | 520 5th Street Nw, Northern Pines Mental Health, Brainerd, MN 56401-5700 | 2017-03-29 |
| 1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
| 1063887370 | Lara Royer | Social Worker | 716 E St Ne, Brainerd, MN 56401-2857 | 2015-12-11 |
| 1134497050 | Jane Terese Monson | Social Worker | 318 W Laurel St, Brainerd, MN 56401-4077 | 2011-12-06 |
| 1295992907 | Lynnette Yvonne Wagner | Social Worker | 18101 Hartley Dr, Brainerd, MN 56401-7915 | 2008-05-20 |
| 1386774610 | Stuart James Popkin | Social Worker | 520 5th St. N.w., Brainerd, MN 56401 | 2007-03-06 |
| 1619591807 | Sarah Timpane | Social Worker | 823 Maple St, Brainerd, MN 56401-3770 | 2020-06-03 |
| 1538794524 | Shae Edgerton | Social Worker | 823 Maple St, Brainerd, MN 56401-3770 | 2020-03-10 |
| 1043857774 | Amanda Mary Kampa | Social Worker | 823 Maple St, Brainerd, MN 56401-3770 | 2019-12-02 |
| Find all providers in BRAINERD | ||||
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| 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.