David Jackson, LICSW
Social Worker, Clinical in Pine City, MN. Individual provider (NPI-1).
NPI number1548972425
StatusActive
Last updated in NPPESDec 22, 2022
Details
- NPI
- 1548972425
- Entity type
- Individual (NPI-1)
- Name
- David Jackson
- Credential
- LICSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 22, 2022
- Certification date
- Dec 22, 2022
- Last updated
- Dec 22, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 21551 | MN | Yes |
Practice location
220 Railroad St SePine City, MN 55063-1540
Phone 320-629-7600
Mailing address
220 Railroad St SePine City, MN 55063-1540
Phone 320-629-7600
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Other Clinical Social Worker providers in Pine City, MN
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- Karlie Gams, MSW, LICSWNPI 1194350199
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All 17 Clinical Social Worker providers in Pine City · All 183 providers in Pine City
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