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KETAJIA JACKSON LPC
NPI 1114864188
Counselor - Mental Health in Chicago, IL

Active since April 29, 2026
3605 W FILLMORE ST, CHICAGO, IL 60624(773) 588-0180 Get Directions Write a Review

NPPES record last updated: April 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ketajia Jackson Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETAJIA JACKSON LPC (NPI 1114864188) is an individual mental health provider in Chicago, Illinois, licensed in Illinois (178018536) and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1114864188
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKETAJIA JACKSONCredential: LPC
Location Address3605 W FILLMORE STChicago, IL 60624-4310
Mailing Address4213 S Wells St Apt 2Chicago, IL 60609-2813 · (773) 679-8324
Phone(773) 588-0180
Sole ProprietorYes
Enumeration DateApril 29, 2026
NPPES CertifiedApril 29, 2026
✔ NPI 1114864188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IL · 178018536
3605 W FILLMORE ST, Chicago, IL 60624
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE KOHN LPC
Counselor (Professional)
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (773) 588-0180
RACHAEL SIEMON-CAROME LCSW
Social Worker (Clinical)
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (773) 696-3790
VIVIANA RUIZ MSW
Counselor (Mental Health)
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (773) 588-0180
MR. RAYMOND SCOTT PFLEDDERER LSW
Social Worker
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (773) 588-0180
SHAOXUAN WANG LCSW
Social Worker (Clinical)
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (312) 618-0135
DEJANAE BYRD LPC
Counselor (Professional)
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (773) 588-0180
PASQUAIL COOK MSW
Social Worker (Clinical)
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (773) 615-4942
APRIL TOBAR
Counselor
3605 W FILLMORE ST
CHICAGO, IL 60624
Cook County (773) 501-0713

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ketajia Jackson's NPI number?

The NPI number for Ketajia Jackson is 1114864188. It was assigned to this individual provider in the NPPES registry on April 29, 2026.

Where is Ketajia Jackson located?

Ketajia Jackson practices at 3605 W Fillmore St, Chicago, IL 60624. The listed phone number is (773) 588-0180.

What is Ketajia Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Ketajia Jackson was last updated on April 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.