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

Domenica Raegene Nycole Jackson

Individual provider Social Worker · NPI 1922870179

Domenica Raegene Nycole Jackson is a Social Worker in Russellville, Alabama. Licensed in Alabama. Registered with an NPI since 2023.

Licensed in
AL
In the registry since
2023

Practice location Address checks out

12260 Highway 43
Russellville, AL 35653-4737
Phone: (256) 710-8558
Show map & directions

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

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 6371G (AL)

Record details

NPI number1922870179
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 23, 2023
Last updated in NPPESMarch 3, 2024
Certification dateMarch 3, 2024

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