Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jessica Amber Bazan Deraedt, LMSW

Individual provider Clinical Social Worker · NPI 1083170963

Mrs. Jessica Amber Bazan Deraedt, LMSW is a Clinical Social Worker in Jackson, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2019
What do these letters mean?
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

1108 Homewild Ave
Jackson, MI 49201-1835
Phone: (231) 679-0648
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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 6801101750 (MI)

Record details

NPI number1083170963
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMSW
Sole proprietorYes
NPI enumeratedFebruary 15, 2019
Last updated in NPPESJuly 17, 2020
Certification dateJuly 17, 2020

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