Active NPI
Kiara Jackson
- Social Worker
- Washington, DC
National Provider Identifier
1205729050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LG200002645
- Practice address
- 1049 48TH PL NE
Washington, DC 20019-3912 - Phone
- (202) 706-0740
- NPI assigned
- May 30, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 35365 | MD | |
| Social Worker | 104100000X | LG200002645 | DC | Primary |
Addresses
Primary practice location
1049 48TH PL NE
Washington, DC 20019-3912
Mailing address
3305 Randall Rd
Suitland, MD 20746-2146
Phone (202) 706-0740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LG200002645 | DC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1205729050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3305 RANDALL RD",
"city": "SUITLAND",
"state": "MD",
"postal_code": "207462146",
"telephone_number": "202-706-0740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1049 48TH PL NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200193912",
"telephone_number": "202-706-0740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KIARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-30",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "35365",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "DC",
"license": "LG200002645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.