Sara Jackson, LSCSW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCAC00802 Issued in KS

Practice address

4810 State Ave
Kansas City, KS 66102-1748

Phone

(816) 221-0305

Fax

(816) 221-9121

NPI assigned

Jul 2, 2020

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

Other names 1

• Sara Sisson Other name

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": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1194342436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7129 PENNSYLVANIA AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64114",
            "telephone_number": "816-589-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021748",
            "telephone_number": "816-221-0305",
            "fax_number": "816-221-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "SARA",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2025-09-11",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "LCAC00802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "SISSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lateasha C Jackson
• Mollie J Jackson, DO
• Quinn Michelle Jackson, M.D.
• Randolph Thomas Jackson, M.D.
• Robert Sean Jackson, M.D.
• Seth Jackson, DPT
• Susan T Jackson, PHD, MSC
• Tara L Jackson, APRN
• Victoria Jackson, CNA
• James Seth Jacob, MD

• Addiction (Substance Use Disorder) Counselor in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Addiction (Substance Use Disorder) Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.