Laurie Ann Jackson, LCSW R
NPI 1104907187ActiveIndividual· Social Worker, Clinical· Rego Park, NY
Social Worker, Clinical (LCSW R) with Outreach Development Corporation, practicing in Rego Park, New York. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1104907187 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW R |
| Sole proprietor | Yes |
| NPI issued | Oct 18, 2006 |
| Last updated in NPPES | Jul 9, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | R056949-1 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (NY) |
|---|
Education and affiliations
| Graduation year | 1997 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Outreach Development CorporationRichmond Hill, NY · 9 clinicians
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