Most Relevant Information
Provider Data
| NPI Number: | 1003378241 |
| Provider Name: | KASEY B JACKSON LCSW-S |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 52150 |
Most Important Dates
| Enumeration Date: | 04/05/2019 |
| Last Updated: | 04/05/2019 |
Provider Practice Location
12120 MANCHACA RD
AUSTIN
TX
787482710
Practice Location Phone/Fax
| Phone: | 5129604533 |
| Fax: |
Provider Mailing Location
1221 W BEN WHITE BLVD STE 210A
AUSTIN
TX
787047182
Provider Mailing Phone/Fax
| Phone: | 5129604553 |
| Fax: | 5128873970 |