{"npi":"1164080693","type":"NPI-2","status":"active","name":{"display":"Jackson Therapy","other":[],"organization_name":"JACKSON THERAPY","authorised_official":"Angela Jackson"},"specialty":{"primary_taxonomy":"1041C0700X","primary_taxonomy_description":"Clinical Social Worker","slug":"clinical-social-worker","schema_org_specialty":null,"all":[{"code":"1041C0700X","description":"Clinical Social Worker","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"404 W GREEN ST","city":"URBANA","state":"IL","postal_code":"618013267","country_code":"US","phone":"2177065498","fax":"2177065779"},{"purpose":"MAILING","street_1":"230 W MAIN ST","city":"DECATUR","state":"IL","postal_code":"625231215","country_code":"US","phone":"2177065498"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20230411002542","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"IL","pac_id":"5496120198"}]},"enumeration_date":"2019-05-30","last_updated":"2023-03-30","_meta":{"source":"NPPES","snapshot_date":"2023-03-30","doc_url":"https://findmynpi.com/api"}}