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

MS. Laurie Ann Jackson, LCSWR

Individual provider Clinical Social Worker · NPI 1104907187

MS. Laurie Ann Jackson, LCSWR is a Clinical Social Worker in Rego Park, New York. Qualified in 1997, 29 years ago. Practices with Outreach Development Corporation, a 7-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
29
Licensed in
NY
In the registry since
2006
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

9745 Queens Blvd Ph Fl
Rego Park, NY 11374-2101
Phone: (718) 896-9090
Fax: (718) 830-0724
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence R056949-1 (NY)

Record details

NPI number1104907187
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSWR
Sole proprietorYes
NPI enumeratedOctober 18, 2006
Last updated in NPPESJuly 9, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Outreach Development Corporation — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rego Park