What is Keanu Jackson's NPI number?

Keanu Jackson's National Provider Identifier (NPI) is 1740807411, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Keanu Jackson's specialty?

Keanu Jackson is listed in the NPPES registry with a primary specialty of Social Worker (Behavioral Health & Social Service Providers).

Where is Keanu Jackson located?

Keanu Jackson's practice location on file with NPPES is 836 Bergen St Apt 112, Brooklyn, NY 11238-7455.

What is Keanu Jackson's phone number?

The practice phone number listed in the NPPES registry for Keanu Jackson is (772) 834-8567.

Is Keanu Jackson's NPI active?

Yes — Keanu Jackson's NPI (1740807411) is active in the NPPES registry as of the last update on 2025-03-17.

IndividualActive

Keanu Jackson, LCSW

NPI 1740807411 · Social Worker · Brooklyn, NY

Keanu Jackson, LCSW is a Social Worker provider in Brooklyn, NY (NPI 1740807411).

Provider details

NPI number: 1740807411
Entity type: Individual
Primary specialty: Social WorkerBehavioral Health & Social Service Providers
Credential: LCSW
Sex: Male
Sole proprietor: Yes
License: 096448 (NY)

Specialties & taxonomies

Social WorkerPrimary104100000XLicense 096448 (NY)
Behavioral Health & Social Service Providers

Profile Score

Established profile(64/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
5 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

836 Bergen St Apt 112

Brooklyn, NY 11238-7455

Phone: (772) 834-8567

Street-level locationGet directions

More NY providers

Mailing address