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MS. PENELOPE JACKSON ACKLEY LICSW NPI 1447309950


NPI Information

NPI: 1447309950
Provider Name: MS. PENELOPE JACKSON ACKLEY, LICSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
52 BREWSTER RD
BROCKTON, MA
ZIP 02301
Phone: (508) 588-2441
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MS. Penelope Jackson Ackley, LICSW is a clinical social worker in Brockton, MA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MS. Penelope Jackson Ackley, LICSW NPI is 1447309950. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

52 BREWSTER RD
BROCKTON, MA
ZIP 02301-810
Phone: (508) 588-2441

The enumeration date for this NPI number is 1/10/2007 and was last updated on 5/27/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical1016736MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OTT000MEDICARE UPINMASSACHUSETTS
262-07081OTHERMASSACHUSETTSEVERCARE
3P04958OTHERMASSACHUSETTSBLUE CROSS
4P04858MEDICARE PINMASSACHUSETTS
5P00437517MEDICARE PINMASSACHUSETTS
61851004MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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