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

Jatayvia Jaqae Jackson, LLMSW

Individual provider Technician/Technologist · NPI 1174012389

Jatayvia Jaqae Jackson, LLMSW is a Technician/Technologist in Saginaw, Michigan. Works from 2 locations. Licensed in Michigan.

Licensed in
MI
In the registry since
2018
Specialties on file
2

Practice location Address checks out

3253 Congress Ave
Saginaw, MI 48602-3106
Phone: (989) 475-4171
Fax: (989) 393-6021
Show map & directions

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

Additional practice locations (1)

  • 32100 Telegraph Rd Ste 205, Bingham Farms, MI 48025-2454 — (248) 712-4266

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6851115529 (MI)
Technician/Technologist Taxonomy 156F00000X

Record details

NPI number1174012389
Entity typeIndividual (Type 1)
GenderFemale
Credentials LLMSW
Sole proprietorNo
NPI enumeratedMay 2, 2018
Last updated in NPPESApril 8, 2023
Certification dateApril 8, 2023

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