Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackson Innovations PLLC

Organization Clinical Social Worker · NPI 1750405734

Jackson Innovations PLLC is a Clinical Social Worker in Southfield, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

20700 Civic Center Dr Ste 170
Southfield, MI 48076-4140
Phone: (248) 569-9846
Fax: (248) 569-1919
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801059515 (MI)

Record details

NPI number1750405734
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gaynella Jackson — Clinical Director · (248) 569-9846
NPI enumeratedMarch 16, 2007
Last updated in NPPESAugust 22, 2020
Mailing address20700 Civic Center Dr, Suite 170, Southfield, MI 48076-4140

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