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Active NPI 1548972425 Individual Practitioner Male Practitioner

David Jackson , LICSW

Social Worker - Clinical • Pine City, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

David Jackson, LICSW is a certified Social Worker - Clinical practicing in Pine City, MN. With approximately 10 years of clinical experience since completing medical education in 2016, David Jackson delivers high-quality medical care to the local community at 220 RAILROAD ST SE.

David Jackson is affiliated with Therapeutic Services Agency Inc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

220 Railroad St Se

Pine City, MN 550631540

Telephone 3206297600
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2016

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker - Clinical in Pine City, MN

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
10 Yrs -0.5 yrs vs City Avg
City Avg: 10.5 Yrs
State Avg: 15.5 Yrs
Regional Practice Density
17 Specialists

Practicing in Pine City, MN (6749 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jackson (10 Years) 10 Yrs
Pine City Specialty Average (10.5 Years) 10.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2022-12-22
Social Worker - Clinical Primary Specialty

NUCC Taxonomy Code: 1041C0700X

State License MN 21551

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
21551 (MN)

Hospital & Practice Group Affiliations

Therapeutic Services Agency Inc

705 Hillside Ave Se, Pine City, MN 550631466

Phone: 3206297600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Nathan Vojtech , LMFT

Marriage & Family Therapist

NPI 1003186412

Licensed Marriage and Family Therapist

Dr. Samantha Rogers , PsyD, LP

Psychologist - Clinical

NPI 1033928932

Doctor of Psychology (Psy.D.), Licensed Psychologist

Janice Reich , LMFT

Marriage & Family Therapist

NPI 1053414821

Licensed Marriage and Family Therapist

Cara Howard , LPCC

Counselor - Professional

NPI 1073890448

Licensed Professional Clinical Counselor

NPI 1093006827

Master of Social Work, Licensed Independent Clinical Social Worker

Bethany Cleary , MA, LPCC

Counselor - Professional

NPI 1104317445

Master of Arts, Licensed Professional Clinical Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active December 22, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location December 22, 2022

Registered at 220 RAILROAD ST SE, PINE CITY, MN 550631540 (Tel: 3206297600)

📍
Updated Business Mailing Address December 22, 2022

Registered at 220 RAILROAD ST SE, PINE CITY, MN 550631540 (Tel: 3206297600)

👤
Provider Name / Credentials Updated December 22, 2022

Recorded as DAVID JACKSON, LICSW

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 22, 2022

Social Worker (License #21551 in MN)

🟢
Initial NPI Registration & Enumeration December 22, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1548972425
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 22, 2022
Last Update: December 22, 2022
Sole Proprietor: No

Mailing Address

220 Railroad St Se

Pine City, MN 550631540

Phone: 3206297600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.