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

Mr. Deric R Jackson, LICSW

Individual provider Clinical Social Worker · NPI 1093423337

Mr. Deric R Jackson, LICSW is a Clinical Social Worker in Hastings, Minnesota. Licensed in Minnesota. Registered with an NPI since 2022.

Licensed in
MN
In the registry since
2022
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1320 S Frontage Rd Ste 200
Hastings, MN 55033-2481
Phone: (651) 500-0905
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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 21544 (MN)

Record details

NPI number1093423337
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedNovember 7, 2022
Last updated in NPPESNovember 28, 2022
Certification dateNovember 28, 2022
Mailing address1320 S Frontage Rd, Hastings, MN 55033-2684

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