National Provider Identifier

Courtney Jackson, LMSW

Courtney Jackson, LMSW is listed in the NPPES registry with a primary specialty of School Social Worker in Rochester, NY and a listed phone number of (585) 324-9273.

NPI 1417679473Rochester, NYSchool Social Worker

Profile Overview

NPI
1417679473
Provider Type
Individual
Primary Specialty
School Social Worker
Enumeration Date
September 16, 2022
Last Updated
September 16, 2022

Practice Location

  • 4115 Lake Ave
  • Rochester, NY 14612-4813

Phone: (585) 324-9273

Mailing Address

  • 211 Collingwood Dr
  • Rochester, NY 14621-1016

Specialties

  • School Social Worker (1041S0200X)
  • Clinical Social Worker (1041C0700X)
  • Social Worker (104100000X)
Full Record
NPI
1417679473
Entity Type
Individual
Last Name
Jackson
First Name
Courtney
Credential
LMSW
Provider Other Last Name
Jackson-Troupe
Provider Other First Name
Courtney
Provider Other Name Prefix Text
Mr.
Provider Other Credential Text
LMSW
Provider Other Last Name Type Code
5
Mailing Street Address
211 Collingwood Dr
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14621-1016
Mailing Country
US
Mailing Phone
(585) 472-6253
Practice Street Address
4115 Lake Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14612-4813
Practice Country
US
Practice Phone
(585) 324-9273
Enumeration Date
September 16, 2022
Last Updated
September 16, 2022
Sex
Female
Sole Proprietor
No
Certification Date
September 16, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
School Social Worker (1041S0200X), Clinical Social Worker (1041C0700X), Social Worker (104100000X)