Ebony Chantrice Jackson, CHW INSTRUCTOR

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

794 Issued in TX

Practice address

11510 Homestead Rd Ste 295
Houston, TX 77016-1237

Phone

(713) 816-1629

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Ebony Chantrice Anderson Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CDJ Caring Does Justice Foundation

  • Community/Behavioral Health Agency
  • Houston, TX
  • NPI 1457948796
  NPD

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1336749597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15267 MORNING DOVE DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773962294",
            "telephone_number": "281-736-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11510 HOMESTEAD RD STE 295",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770161237",
            "telephone_number": "713-816-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EBONY",
        "middle_name": "CHANTRICE",
        "name_prefix": "Mrs.",
        "credential": "CHW INSTRUCTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "TX",
            "license": "794",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": "794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "caringdoesjusticefoundation@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email addrss",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11510 Homestead Rd Ste 295",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770161237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebonycjack@caringdoesjusticefoundation.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11510 Homestead Rd Ste 295",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770161237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EBONY",
            "last_name": "ANDERSON",
            "middle_name": "CHANTRICE",
            "credential": "CHW INSTRUCTOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Demetris Jackson, LMT
• Denise Mason Jackson
• Deschan Jackson
• Donny G Jackson Jr., RN
• Dorothy Octavia Jackson, PH.D.
• Emily Jackson
• Eric Jackson
• Erika Jackson, PT
• Evelyn K. Jackson, MS, RN, FNP-C
• Felecia Jackson

• Community Health Worker in Houston, TX
• Providers in Houston, TX by specialty
• Community Health Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.