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

Tiffany Chavon Jackson

Individual provider Clinical Social Worker · NPI 1619893807

Tiffany Chavon Jackson is a Clinical Social Worker in Saint Louis, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2026

Practice location Address checks out

5022 Potomac St
Saint Louis, MO 63139-1317
Phone: (314) 688-0635
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 2025044034 (MO)

Record details

NPI number1619893807
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 24, 2026
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026

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