Individual
KEISHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3324 RUE ROYALE ST STE 125, SAINT CHARLES, MO 63301-8321
(314) 685-0061
Mailing address
3324 RUE ROYALE ST STE 125, SAINT CHARLES, MO 63301-8321
(314) 685-0061
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2025048875
MO
Other
Enumeration date
03/13/2026
Last updated
04/29/2026
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