Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Nyles Antony Jackson, MSW, APSW, SAC-IT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1053637629

Mr. Nyles Antony Jackson, MSW, APSW, SAC-IT is a Clinical Social Worker in Kenosha, Wisconsin. Qualified in 2009, 17 years ago. Practices with Oakwood Clinical Associates, Ltd, a 3-clinician group. Licensed in Wisconsin.

Years since qualifying
17
Licensed in
WI
In the registry since
2010
Specialties on file
2
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.

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Practice location Address checks out

4109 67th St
Kenosha, WI 53142-3836
Phone: (262) 652-9830
Fax: (262) 652-2931
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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 128033-121 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 15877-130 (WI)

Record details

NPI number1053637629
Entity typeIndividual (Type 1)
GenderMale
Credentials MSW , APSW , SAC-IT
Sole proprietorNo
NPI enumeratedApril 7, 2010
Last updated in NPPESApril 7, 2010

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Oakwood Clinical Associates, Ltd — 3 clinicians
Accepts Medicare assignment Not indicated

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