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DR. KEZIA JACKSON PSY.D.
NPI 1790233153
Psychologist - Clinical in Clayton, MO

Active since September 14, 2016Opted out of Medicare · through Jul 25, 2027
7711 BONHOMME AVE STE 720, CLAYTON, MO 63105(314) 968-2350 Get Directions Write a Review

NPPES record last updated: October 16, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Oct 16, 2023, Jun 23, 2020, Sep 7, 2018 and 2 more (5 updates tracked since 2016).

About Dr. Kezia Jackson Psy.d. NPPES

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

DR. KEZIA JACKSON PSY.D. (NPI 1790233153) is an individual clinical provider in Clayton, Missouri, licensed in Missouri (2016035936) and active in the NPI registry since September 2016. She has opted out of Medicare through July 25, 2027.

NPPES Registry Identity

NPI1790233153
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KEZIA JACKSONCredential: PSY.D.
Location Address7711 BONHOMME AVE STE 720Clayton, MO 63105-1908
Mailing Address7711 Bonhomme Ave Ste 720Clayton, MO 63105-1908 · (314) 968-2350
Phone(314) 968-2350
Sole ProprietorNo
Enumeration DateSeptember 14, 2016
Last NPPES UpdateOctober 16, 20235 updates tracked since enumeration
NPPES CertifiedOctober 16, 2023
✔ NPI 1790233153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MO · 2016035936
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologistTaxonomy 103T00000X
7711 BONHOMME AVE STE 720, Clayton, MO 63105
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kezia Jackson Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 25, 2025 through July 25, 2027.

Opt-Out Effective DateJuly 25, 2025
Opt-Out In Effect ThroughJuly 25, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

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

TA'NIA M JORDAN PLPC
Counselor (Mental Health)
7711 BONHOMME AVE STE 720
CLAYTON, MO 63105
St. Louis County (314) 472-3091
SHONDA HOWARD
Social Worker (Clinical)
7711 BONHOMME AVE STE 720
CLAYTON, MO 63105
St. Louis County (314) 472-3091
VICTORIA KYLES LPC
Counselor (Mental Health)
7711 BONHOMME AVE STE 720
CLAYTON, MO 63105
St. Louis County (314) 472-3091

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 Kezia Jackson's NPI number?

The NPI number for Kezia Jackson is 1790233153. It was assigned to this individual provider in the NPPES registry on September 14, 2016.

Where is Kezia Jackson located?

Kezia Jackson practices at 7711 Bonhomme Ave Ste 720, Clayton, MO 63105. The listed phone number is (314) 968-2350.

What is Kezia Jackson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Kezia Jackson enrolled in Medicare?

No. Kezia Jackson has opted out of Medicare through July 25, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Kezia Jackson accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 2 other insurers list Kezia Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kezia Jackson was last updated on October 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.