MR. RICHARD ALLEN JACKSON LICSW NPI 1629520770

NPI Information

  • NPI: 1629520770
  • Provider Name: MR. RICHARD ALLEN JACKSON, LICSW
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 201 W LAUREL ST
    BRAINERD, MN
    ZIP 56401
  • Phone: (218) 454-3844

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NPI Details

MR. Richard Allen Jackson, LICSW is a clinical social worker in Brainerd, MN. The provider is 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. MR. Richard Allen Jackson, LICSW NPI is 1629520770. 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:

201 W LAUREL ST
BRAINERD, MN
ZIP 56401-902
Phone: (218) 454-3844
Fax: (218) 454-3844

The enumeration date for this NPI number is 10/25/2016 and was last updated on 4/12/2018.

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
11041C0700XSocial WorkerClinical23282MINNESOTAYes

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: 3/30/2025

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