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

Samantha Liverpool-Jackson

Individual provider Mental Health Counselor · NPI 1497419683

Samantha Liverpool-Jackson is a Clinical Social Worker in Conyers, Georgia. Qualified in 2017, 9 years ago. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2021

Practice location Address checks out

1387 Mourning Dove Dr SW
Conyers, GA 30094-5761
Phone: (404) 593-0516
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 010154 (GA)

Record details

NPI number1497419683
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 25, 2021
Last updated in NPPESApril 14, 2026
Certification dateApril 14, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Conyers