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

Andrea Lane Jackson, LICSW, LCSW

Individual provider Social Worker · NPI 1679003099

Andrea Lane Jackson, LICSW, LCSW is a Clinical Social Worker in Washington, District of Columbia. Qualified in 2012, 14 years ago. Practices as a sole proprietor. Licensed in District of Columbia, New York and Virginia.

Years since qualifying
14
Licensed in
DC, NY, VA
In the registry since
2017
Specialties on file
4
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1763 Columbia Rd NW Ste 175
Washington, DC 20009-2891
Phone: (202) 318-3997
Fax: (202) 318-0501
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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 LC200003614 (DC)
Social Worker Taxonomy 104100000X · Licence 087822 (NY)
Clinical Social Worker Taxonomy 1041C0700X · Licence 0904017420 (VA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 091378 (NY)

Record details

NPI number1679003099
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW , LCSW
Sole proprietorYes
NPI enumeratedJune 18, 2017
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Not indicated

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