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

MS. Michelle Marie Jack, LCSW

Individual provider Clinical Social Worker · NPI 1386043503

MS. Michelle Marie Jack, LCSW is a Clinical Social Worker in San Diego, California. Licensed in California. Registered with an NPI since 2014.

Licensed in
CA
In the registry since
2014
Specialties on file
2
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

409 Camino Del Rio S Ste 201
San Diego, CA 92108-3505
Phone: (619) 813-9184
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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 LCSW96801 (CA)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1386043503
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 14, 2014
Last updated in NPPESFebruary 17, 2022
Certification dateFebruary 17, 2022

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