Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Antimoore H. Jackson, LCSW

Individual provider Clinical Social Worker · NPI 1376756098

Mr. Antimoore H. Jackson, LCSW is a Clinical Social Worker in Little Rock, Arkansas. Practices as a sole proprietor. Licensed in Arkansas.

Licensed in
AR
In the registry since
2007
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

14617 Sara Dr
Little Rock, AR 72206-5410
Phone: (501) 952-5275
Fax: (501) 888-3576
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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 1568-C (AR)

Record details

NPI number1376756098
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 8, 2007
Last updated in NPPESJuly 9, 2007

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