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

Samantha Nailah Mitchelle Jackson

Individual provider Clinical Social Worker · NPI 1720653603

Samantha Nailah Mitchelle Jackson is a Clinical Social Worker in Carson, California. Licensed in California. Registered with an NPI since 2021.

Licensed in
CA
In the registry since
2021
Specialties on file
4

Practice location Address checks out

649 E Albertoni St Ste 100
Carson, CA 90746-1538
Phone: (310) 436-9300
Show map & directions

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 137898 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 102031 (CA)
Mental Health Counselor Taxonomy 101YM0800X · Licence ACSW102031 (CA)
Social Worker Taxonomy 104100000X · Licence ACSW102031 (CA)

Record details

NPI number1720653603
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 24, 2021
Last updated in NPPESApril 30, 2026
Certification dateApril 30, 2026

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