Active NPI
Keisha Star Jackson, MSW,CADC
- Community Health Worker
- Prestonsburg, KY
National Provider Identifier
1932784493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 104 S Front Ave
Prestonsburg, KY 41653-1614 - Phone
- (606) 886-8572
- Fax
- (606) 886-4433
- NPI assigned
- Mar 16, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
104 S Front Ave
Prestonsburg, KY 41653-1614
Mailing address
130 Fountain Ave
Paducah, KY 42001-2713
Phone (270) 201-2055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Divine Transitions LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Paducah, KY
- NPI 1023827854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784851200000",
"number": "1932784493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 FOUNTAIN AVE",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420012713",
"telephone_number": "270-201-2055",
"fax_number": "270-713-0638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 S FRONT AVE",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416531614",
"telephone_number": "606-886-8572",
"fax_number": "606-886-4433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KEISHA",
"middle_name": "STAR",
"credential": "MSW,CADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-16",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prestonsburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.