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

Individual provider Clinical Social Worker · NPI 1922406842

Mellissa Forde-Jackson, LCSW is a Clinical Social Worker in Fayetteville, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2014
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

911 Hay St
Fayetteville, NC 28305-5313
Phone: (910) 827-6649
Fax: (910) 438-0942
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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 C010681 (NC)

Record details

NPI number1922406842
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedDecember 9, 2014
Last updated in NPPESMarch 8, 2023
Certification dateMarch 3, 2023

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