DAMIEN JACKSON NPI 1588256424

NPI Information

  • NPI: 1588256424
  • Provider Name: DAMIEN JACKSON
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 201 MAPLEWOOD AVE
    MUNDELEIN, IL
    ZIP 60060
  • Phone: (773) 234-4808

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NPI Details

Damien Jackson is a clinical social worker in Mundelein, IL with 14 years of experience. 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. Damien Jackson NPI is 1588256424. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduation Year:2012

The provider's business location address is:

201 MAPLEWOOD AVE
MUNDELEIN, IL
ZIP 60060-129
Phone: (773) 234-4808

The NPI 1588256424 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychiatric diagnostic evaluation (HCPCS:90791)

The enumeration date for this NPI number is 2/10/2021 and was last updated on 2/10/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinical149021097ILLINOISYes

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: 11/21/2025

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