Jackson Therapy

Clinical Social Worker · Urbana, IL

Organization Active NPI

NPI number 1164080693

Practice location

404 W Green St
Urbana, IL 61801-3267
Phone
(217) 706-5498
Fax
(217) 706-5779

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NPI record

NPI
1164080693
Entity type
Organization (Type 2)
Enumeration date
May 30, 2019
Last updated
March 30, 2023
Certified
March 30, 2023
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X — —

Mailing address

230 W Main St
Decatur, IL 62523-1215
Phone
(217) 706-5498

Authorized official

Name
Angela Jackson, LCSW
Title
Owner/Lead Therapist
Phone
(217) 840-4090

About Jackson Therapy

Jackson Therapy is a healthcare organization registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 404 W Green St, Urbana, IL 61801-3267. The NPI number 1164080693 was assigned on May 30, 2019 and the record was last updated on March 30, 2023.

The authorized official for this organization is Angela Jackson, LCSW, Owner/Lead Therapist.

Frequently asked questions

What is the NPI number of Jackson Therapy?

The NPI number is 1164080693.

What is the phone number of Jackson Therapy?

The phone number listed for the practice location is (217) 706-5498.

Where is Jackson Therapy located?

404 W Green St, Urbana, IL 61801-3267.

What is the taxonomy code for Jackson Therapy?

The primary taxonomy code is 1041C0700X – Clinical Social Worker.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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