Individual
KENNETH DAVID JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
3901 ULLOA ST, NEW ORLEANS, LA 70119-6942
(504) 267-5712
(504) 267-5714
Mailing address
3901 ULLOA ST, NEW ORLEANS, LA 70119-6942
(504) 267-5712
(504) 267-5714
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
17790
LA
104100000X
Social Worker
Primary
17790
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/21/2015
Last updated
05/08/2025
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