Kwajera Zakiyah Jackson, MSW, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14992 Issued in MD

Practice address

1325 Bedford Ave Unit 5704
Pikesville, MD 21282-7501

Phone

(443) 272-1526

NPI assigned

Nov 1, 2012

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Iama Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pikesville, MD
  • NPI 1295443992
  NPD Authorized official
• Aspire Wellness Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nottingham, MD
  • NPI 1780971630
  NPD

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1932453636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 BEDFORD AVE UNIT 5704",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212827501",
            "telephone_number": "443-272-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 BEDFORD AVE UNIT 5704",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212827501",
            "telephone_number": "443-272-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KWAJERA",
        "middle_name": "ZAKIYAH",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3700C-1210",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114312300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia R Jackson
• Cynthia Mary Jackson, LCSW-C
• Ebony Jackson
• Imani Jean Jackson
• Kelli Jackson, RN
• Montera Jackson
• Shanica Michelle Jackson
• Tayaunna Maree Jackson
• Howard Terry Jacobs, MD
• Jacquette Jacobs, LCPC

• Clinical Social Worker in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.