Kesha N. Jackson, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.1201283 Issued in OH

Practice address

117 Main Street
Suite B
Toledo, OH 43605-2209

Phone

(419) 725-1415

Fax

(419) 389-6284

NPI assigned

Nov 28, 2016

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

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.

• Catalyst for Change

  • Clinical Social Worker
  • Toledo, OH
  • NPI 1871180752
  NPD Authorized official

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1528501491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 TEDROW RD",
            "address_2": "SUITE 420",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143859",
            "telephone_number": "419-725-1415",
            "fax_number": "419-389-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MAIN STREET",
            "address_2": "SUITE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052209",
            "telephone_number": "419-725-1415",
            "fax_number": "419-389-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KESHA",
        "middle_name": "N.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1201283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Jackson, A.A.
• Julie Marie Jackson, OT
• Kayleah Jackson
• Keiyona T Jackson
• Kenesha Jackson
• Kimberly Jackson, RDN, LD
• Kyndra Jackson
• Laeia B Jackson, MD
• Leonna Jackson, LISW
• Lindsey Jackson, DO

• Clinical Social Worker in Toledo, OH
• Providers in Toledo, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.