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DERRICK JACK LSW NPI 1265096994


NPI Information

NPI: 1265096994
Provider Name: DERRICK JACK, LSW
Classification: Social Worker - 104100000X
Entity Type: Individual
Address:
2627 CHARLESTOWN RD
NEW ALBANY, IN
ZIP 47150
Phone: (812) 944-1550
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Derrick Jack, LSW is a social worker in New Albany, IN. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. Derrick Jack, LSW NPI is 1265096994. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2627 CHARLESTOWN RD
NEW ALBANY, IN
ZIP 47150-536
Phone: (812) 944-1550

The enumeration date for this NPI number is 4/29/2019 and was last updated on 4/29/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial Worker33008477AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.