Individual
AYANNA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3518 W 25TH ST, CLEVELAND, OH 44109-1951
(216) 741-2241
(216) 739-3638
Mailing address
3518 W 25TH ST, CLEVELAND, OH 44109-1951
(216) 741-2241
(216) 739-3638
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2207882
OH
1041C0700X
Clinical Social Worker
Primary
I.2607795
OH
Other
Enumeration date
12/03/2020
Last updated
02/26/2026
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