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

Kyler Jackson

Individual provider Social Worker · NPI 1386216703

Kyler Jackson is a Clinical Social Worker in Ann Arbor, Michigan. Qualified in 2022, 4 years ago. Licensed in Michigan and Ohio.

Years since qualifying
4
Licensed in
MI, OH
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

4788 Washtenaw Ave Apt B7
Ann Arbor, MI 48108-3113
Phone: (717) 808-7198
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 6851114487 (MI)
Social Worker Taxonomy 104100000X · Licence S.2101858-TRNE (OH)

Record details

NPI number1386216703
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 14, 2021
Last updated in NPPESMay 26, 2022
Certification dateMay 26, 2022
Mailing address415 Glensprings Dr Ste 201, Cincinnati, OH 45246-2353

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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