Antoinette Rae Jackson

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Practice address

3925 N 6TH St
Milwaukee, WI 53212-1139

Phone

(414) 234-7720

NPI assigned

Oct 15, 2025

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1144196387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530920043",
            "telephone_number": "414-234-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 N 6TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121139",
            "telephone_number": "414-234-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ANTOINETTE",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dashia Jackson-Day
• Acelia Jackson
• Adrian D. Jackson
• Aisha Jackson
• Albert Jackson, AODA
• Anwar D Jackson, MD
• Austiana Jackson
• Beatrice Jackson, SUD COUNSELOR SAC
• Brianna Shanice Jackson, PA-C
• Charlesetta Jackson, SAC

• All providers in Milwaukee, WI
• Mental Illness Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.