Kathryn Jackson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2019039418 Issued in MO

Practice address

1033 Fernpark Dr
Saint Louis, MO 63141-6132

Phone

(314) 809-7647

NPI assigned

Apr 24, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1043907611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 FERNPARK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416132",
            "telephone_number": "314-809-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 FERNPARK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416132",
            "telephone_number": "314-809-7647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 N Clay Ave Ste 215",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "MO",
            "postal_code": "631224068",
            "country_code": "US",
            "telephone_number": "314-470-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATHRYN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2019039418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Alegro Jackson
• Jacqueline Jackson
• Jacquelynne Jackson, RN, BSN
• Karin Rochelle Jackson
• Karissa Jackson
• Kathryn E. Jackson, D.O.
• Kathryn M Jackson, RDN
• Keith Jackson
• Kimberly Jackson
• Leonard Douglas Jackson Sr.

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.