Mr. Nyles Antony Jackson is a Kenosha, Wisconsin based counselor with 16 years of experience in Addiction (Substance Use Disorder) Counselor. He completed his graduation from Other in 2009. He may accept the Medicare-approved amount. Patients may be billed for more than the Medicare deductible and coinsurance. Active license number of Mr. Nyles Antony Jackson is 128033-121 for Social Worker in Wisconsin. His current practice location is 4109 67th St, Kenosha. Patients can book an appointment with him at 262-652-9830.
Mr. Nyles Antony Jackson is a licensed mental health therapist who help individuals struggling with addiction of alcohol, drug, or other substance use disorder. He helps his clients by manage and overcome the psychological, emotional, and behavioral challenges related to substance use. Counselors also work closely with families and support systems to help them better understand their loved one’s illness. SUD counselors help to promote long-term sobriety, emotional stability, and overall mental wellness for both the individual and their family.
Complete Profile:
Mr. Nyles Antony Jackson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Mr. Nyles Antony Jackson
Specialization:
Addiction (Substance Use Disorder) Counselor
Gender:
Male
Credentials:
MSW, APSW, SAC-IT
Experience:
16+ years
Medical School Attended:
Other
Graduation Year:
2009
Accepts Medicare Assignment:
May Accept
Practice Address:
4109 67th St, Kenosha, Wisconsin, 53142-3836
Phone:
262-652-9830
Fax:
262-652-2931
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
7810204708
Enrollment ID:
I20150909001658
NPI Number:
1053637629
NPI Enumeration Date:
07 Apr, 2010
NPI Last Update On:
07 Apr, 2010
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Nyles Antony Jackson are as mentioned below.
License Number
Specialization
State
Status
128033-121
Social Worker
Wisconsin
Primary
15877-130
Addiction (Substance Use Disorder) Counselor
Wisconsin
Secondary
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Mr. Nyles Antony Jackson is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Oakwood Clinical Associates, Ltd (8022084383)
3
Medicare Quality Reporting:
Medicare Quality Reporting consists of various programs like PQRS, EHR, MHI etc.
PQRS
He does not participate in the Physician Quality Reporting System Incentive Program.
EHR
He does not participate in the Electronic Health Record Incentive Program.
MHI
He does not participate in the Million Hearts Initiative Program.
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
4109 67th St, Kenosha, Wisconsin
Zip:
53142-3836
Phone Number:
262-652-9830
Fax Number:
262-652-2931
Patients can reach Mr. Nyles Antony Jackson at 4109 67th St, Kenosha, Wisconsin or can call to book an appointment on 262-652-9830. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 June, 2025.