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

Jay Brian Jackson, LCSW

Individual provider Clinical Social Worker · NPI 1730847534

Jay Brian Jackson, LCSW is a Clinical Social Worker in Russellville, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2021
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

13722 Jefferson Rd
Russellville, MO 65074-2006
Phone: (573) 782-0145
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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 2002031992 (MO)

Record details

NPI number1730847534
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedNovember 30, 2021
Last updated in NPPESNovember 30, 2021
Certification dateNovember 30, 2021
Mailing address13722 Jefferson Rd, Russellville, MO 65074-2006