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

Kelly Jackson

Individual provider Clinical Social Worker · NPI 1407522428

Kelly Jackson is a Clinical Social Worker in Cedar Lake, Indiana. Licensed in Indiana. Registered with an NPI since 2021.

Licensed in
IN
In the registry since
2021

Practice location Address checks out

11631 Cedar St
Cedar Lake, IN 46303-7290
Phone: (219) 682-8211
Show map & directions

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34006136A (IN)

Record details

NPI number1407522428
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 19, 2021
Last updated in NPPESAugust 19, 2021
Certification dateJuly 29, 2021
Mailing address11631 Cedar Street, Cedar Lake, In 46303, East Cedar Lake, IN 46303

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