Individual
CASSANDRA L MCKAY-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
132 E 79TH ST, CHICAGO, IL 60619-2302
(773) 487-0515
(773) 487-0525
Mailing address
4906 S INDIANA AVE, CHICAGO, IL 60615-2287
(312) 355-2280
(312) 996-2770
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149005486
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149005486
LICENSE
IL
Enumeration date
04/13/2011
Last updated
04/13/2011
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