KEENAN JACKSON (NPI# 1427417906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427417906 |
| Entity Type | Individual |
| Full Name | KEENAN JACKSON |
| Practice Address |
4449 N 12th St Phoenix AZ 85014-4520 |
| Mailing Address |
Po Box 16906 Phoenix AZ 85011-6906 |
| Practice Telephone | 6022791427 |
| Practice Fax Number | 6022791431 |
| Mailing Telephone | 6022791427 |
| Mailing Fax Number | 6022791431 |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | 6889840 | AZ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073856779 | Keenan Jackson | Occupational Therapist | 6301 Forest Hills Dr Ne, Albuquerque, NM 87109-4137 | 2013-04-01 |
| Street Address |
4449 N 12TH ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85014-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114079290 | Crisetta Allen | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2007-01-17 |
| 1902467293 | Meredith Lashea Williams | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2019-06-26 |
| 1508322637 | Debra Ann Dorris | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2019-02-13 |
| 1689144875 | Kimberly Irene Knaff | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2018-11-29 |
| 1396230314 | Martha Davis | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2018-06-22 |
| 1578056511 | Kenneth Leon Hale II | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2018-06-13 |
| 1003355918 | Lisa Bratcher | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2017-02-13 |
| 1578001723 | Matthew Weyrum | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2017-02-08 |
| 1699212589 | Rosario Quintero | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2017-01-30 |
| 1518319847 | Maurice Jennings | Social Worker | 4449 N 12th St, Phoenix, AZ 85014-4520 | 2016-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796549 | Sherri Ann Rhodes | Registered Nurse | 5727 North 7th Street, Suite 308, Phoenix, AZ 85014 | 2020-10-06 |
| 1235746249 | Kaitlyn Landess | Occupational Therapist | 1190 W. Missouri Ave, Suite 100, Phoenix, AZ 85014 | 2020-09-24 |
| 1467088062 | Generational Bridges Neuropsychological Services Pllc | Clinical Neuropsychologist | 1515 E Missouri Dr, Phoenix, AZ 85014 | 2020-03-16 |
| 1861022881 | Daza Astrid Hernandez | Speech-Language Pathologist | 5314 N 7th Street, Phoeniz, AZ 85014 | 2020-01-17 |
| 1396213542 | Arizona Youth & Family Services Inc. | Community/Behavioral Health | 3707 N. 7th Street, Ste. 200, Phoenix, AZ 85014 | 2018-11-06 |
| 1366815508 | Dehp LLC | Case Management | 3707 N. 7th St., Ste # 310, Phoenix, AZ 85014 | 2015-11-10 |
| 1659751972 | Carla Parola | Counselor | 1300 E Missouri Ave Ste A-120, Phoenix, AZ 85014 | 2015-06-02 |
| 1659763597 | Dale Carroll Davis | Dentist | 3132 N. 7th St, Phoenix, AZ 85014 | 2015-03-02 |
| 1407247091 | Cynthia Ruzich | Psychologist | 1450 E. Indian School Rd. #101, Phoenix, AZ 85014 | 2015-02-18 |
| 1144618315 | Emily M Bentz | Specialist/Technologist | 3514 N. 7th St, Phoenix, AZ 85014 | 2014-12-22 |
| Find all providers in zip 85014 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| 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. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313241 | Kristy Lynn Frieden | Social Worker | 1019 N 1st Dr Unit 237a, Phoenix, AZ 85003-1472 | 2020-07-22 |
| 1235752767 | Ngozichi M. Nwosu | Social Worker | 2902 W Sweetwater Ave Apt 2058, Phoenix, AZ 85029-1375 | 2020-05-19 |
| 1194344630 | Tabatha Saenz | Social Worker | 3636 N Central Ave Ste 200, Phoenix, AZ 85012-1930 | 2020-04-14 |
| 1740812650 | Sarah Ellen Kircher | Social Worker | 13201 N 35th Ave Ste 6b, Phoenix, AZ 85029-1231 | 2020-02-08 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1457999658 | Raelynn Dazny | Social Worker | 4828 N 94th Ln, Phoenix, AZ 85037-1050 | 2019-12-18 |
| 1477191880 | Demarie A Holmes | Social Worker | 7725 W Mcdowell Rd Apt 2010, Phoenix, AZ 85035-6484 | 2019-12-16 |
| 1295378230 | Mica Wilkerson | Social Worker | 19920 N 23rd Ave Apt 2107, Phoenix, AZ 85027-7441 | 2019-10-22 |
| 1245872233 | Afrisia Jones | Social Worker | 2902 W Sweetwater Ave Apt 2155, Phoenix, AZ 85029-1379 | 2019-10-11 |
| 1033751243 | Siara Makalia Mae Lowe | Social Worker | 4221 W Dunlap Ave Apt 219, Phoenix, AZ 85051-3680 | 2019-10-09 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.