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

Individual provider Social Worker · NPI 1669096244

Elijah Jagger Jackson, LCSW is a Social Worker in Philadelphia, Pennsylvania. Practices as a sole proprietor and works from 2 locations. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2020
Specialties on file
2
What do these letters mean?
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

201 S 13th St Apt 1011
Philadelphia, PA 19107-5404
Phone: (631) 346-8485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1500 Walnut St Ste 300, Philadelphia, PA 19102-3502 — (215) 563-7863

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CW023481 (PA)
Social Worker Taxonomy 104100000X

Record details

NPI number1669096244
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 30, 2020
Last updated in NPPESMay 29, 2023
Certification dateMay 28, 2023

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