Active NPI
Kenneth David Jackson Jr., CSW
- Social Worker
- New Orleans, LA
National Provider Identifier
1942674411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 17790
- Practice address
- 3901 Ulloa St
New Orleans, LA 70119-6942 - Phone
- (504) 267-5712
- Fax
- (504) 267-5714
- NPI assigned
- Nov 21, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 17790 | LA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | 17790 | LA | Primary |
Addresses
Primary practice location
3901 Ulloa St
New Orleans, LA 70119-6942
Mailing address
3901 Ulloa St
New Orleans, LA 70119-6942
Phone (504) 267-5712
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17790 | LA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Essential Care Services, 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 Clinic/Center (Including Community Mental Health Center)
- New Orleans, LA
- NPI 1447402144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1942674411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 ULLOA ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701196942",
"telephone_number": "504-267-5712",
"fax_number": "504-267-5714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 ULLOA ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701196942",
"telephone_number": "504-267-5712",
"fax_number": "504-267-5714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KENNETH",
"middle_name": "DAVID",
"name_suffix": "Jr.",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-21",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": "17790",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": "17790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.