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

David Jackson, LICSW

Individual provider Clinical Social Worker · NPI 1548972425

David Jackson, LICSW is a Clinical Social Worker in Pine City, Minnesota. Qualified in 2016, 10 years ago. Practices with Therapeutic Services Agency Inc, a 13-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
10
Licensed in
MN
In the registry since
2022
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

220 Railroad St SE
Pine City, MN 55063-1540
Phone: (320) 629-7600
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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 21551 (MN)

Record details

NPI number1548972425
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedDecember 22, 2022
Last updated in NPPESDecember 22, 2022
Certification dateDecember 22, 2022
Mailing address220 Railroad St Se, Pine City, MN 55063-1540

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Therapeutic Services Agency Inc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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