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MR. NYLES ANTONY JACKSON MSW APSW SAC-IT NPI 1053637629


NPI Information

NPI: 1053637629
Provider Name: MR. NYLES ANTONY JACKSON, MSW, APSW, SAC-IT
Classification: Social Worker - 104100000X
Entity Type: Individual
Organization: OAKWOOD CLINICAL ASSOCIATES, LTD

PECOS Registration: Yes

Address:
4109 67TH ST
KENOSHA, WI
ZIP 53142
Phone: (262) 652-9830
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MR. Nyles Antony Jackson, MSW, APSW, SAC-IT is a social worker in Kenosha, WI with 15 years of experience. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. MR. Nyles Antony Jackson, MSW, APSW, SAC-IT NPI is 1053637629. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4109 67TH ST
KENOSHA, WI
ZIP 53142-836
Phone: (262) 652-9830
Fax: (262) 652-2931

The NPI 1053637629 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 4/7/2010 and was last updated on 4/7/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)15877-130WISCONSINNo
2104100000XSocial Worker128033-121WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.