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

Derrick Jack, LCSW

Individual provider Clinical Social Worker · NPI 1265096994

Derrick Jack, LCSW is a Clinical Social Worker in New Albany, Indiana. Works from 3 locations. Licensed in Indiana.

Licensed in
IN
In the registry since
2019
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

2627 Charlestown Rd
New Albany, IN 47150-2536
Phone: (812) 944-1550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1400 Main St. Ste 196, Clarksville, IN 47129 — (502) 269-4066
  • 425 Watt St, Jeffersonville, IN 47130-3957 — (812) 944-1550

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34012719A (IN)

Record details

NPI number1265096994
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedApril 29, 2019
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026
Mailing address1400 Main St. Ste 196, Clarksville, IN 47129-3121

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