Kegan Elizabeth Jackson, MSW, LGSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

BP00945323 Issued in WV

Practice address

205 Center St
Princeton, WV 24740-2931

Phone

(304) 431-2424

NPI assigned

Sep 17, 2021

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": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1720758055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 REINDEER PL",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247397156",
            "telephone_number": "304-888-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CENTER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402931",
            "telephone_number": "304-431-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KEGAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MSW, LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00945323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J R Willis DC PC (Willis Chiropractic)
• J. Kevin Martin, DDS, PLLC
• J. R. Willis, D.C., P.C. (Willis Chiropractic)
• Tonya R. Jackson-Lockett, NURSE PRACTITIONER
• Alyssa Jackson
• Pricilla Jackson
• Rafael Douglas Jackson
• Tisha James, RD, LD
• Jana Peters
• Andrew Janes, PRSS

• Social Worker in Princeton, WV
• Providers in Princeton, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.