Keviana Y Jackson, MSW, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2022001657 Issued in MO

Practice address

3401 Berrywood Dr Ste 203
Columbia, MO 65201-6515

Phone

(573) 777-2455

NPI assigned

Jan 10, 2024

Last updated

Jul 1, 2025By the provider in NPPES

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": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1518738517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 W BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073952",
            "telephone_number": "417-849-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 BERRYWOOD DR STE 203",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016515",
            "telephone_number": "573-777-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KEVIANA",
        "middle_name": "Y",
        "credential": "MSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-10",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022001657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Duane Jackson, M.D.
• Garrett Jackson, MD
• Hunter Jackson
• Jesse Jose Jackson
• Kelly Faye Jackson, LCSW
• Kimberly Jackson, RN
• Russell Neilend Jackson, PHD
• Markya Jordaine Jaco
• Cynthia Marie Kuhn Jacob, M.S., CCC-SLP
• Janie Louise Jacobs, M.D.

• Clinical Social Worker in Columbia, MO
• Providers in Columbia, 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 Jul 1, 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.