Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim Elaine Jackson, LICSW

Individual provider Clinical Social Worker · NPI 1184275166

Kim Elaine Jackson, LICSW is a Clinical Social Worker in Oakland, California. Licensed in District of Columbia and Washington. Registered with an NPI since 2019.

Licensed in
DC, WA
In the registry since
2019
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

4909 Davenport Ave
Oakland, CA 94619-2920
Phone: (206) 549-4668
Fax: (206) 568-7043
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW61326871 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence LC50082406 (DC)

Record details

NPI number1184275166
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedSeptember 22, 2019
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024

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