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

Angela Jackson, LISW-CP

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1922511419

Angela Jackson, LISW-CP is a Clinical Social Worker in Irmo, South Carolina. Qualified in 2017, 9 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in South Carolina.

Years since qualifying
9
Licensed in
SC
In the registry since
2017
Specialties on file
2

Practice location Address checks out

1180 Columbia Ave Ste 101
Irmo, SC 29063-2890
Phone: (803) 575-0579
Fax: (803) 830-3873
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 13959 (SC)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1922511419
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW-CP
Sole proprietorYes
NPI enumeratedNovember 7, 2017
Last updated in NPPESApril 14, 2023
Certification dateApril 14, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Irmo