1. Home
  2. Directory
  3. Wisconsin
  4. Milwaukee
  5. Counselor
  6. NPI Profile

CHARLESETTA JACKSON SAC
NPI 1922273879
Counselor - Addiction (Substance Use Disorder) in Milwaukee, WI

Active since April 22, 2008
4757 N 76TH ST, MILWAUKEE, WI 53218(414) 358-4171(414) 358-5005 Get Directions Write a Review

NPPES record last updated: April 22, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Charlesetta Jackson Sac NPPES

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

CHARLESETTA JACKSON SAC (NPI 1922273879) is an individual addiction (substance use disorder) provider in Milwaukee, Wisconsin, licensed in Wisconsin (15371-131) and active in the NPI registry since April 2008.

NPPES Registry Identity

NPI1922273879
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameCHARLESETTA JACKSONCredential: SAC
Location Address4757 N 76TH STMilwaukee, WI 53218-4732
Mailing Address4757 N 76th StMilwaukee, WI 53218-4732 · (414) 358-4171 · Fax (414) 358-5005
Phone(414) 358-4171
Fax(414) 358-5005
Sole ProprietorNo
Enumeration DateApril 22, 2008
✔ NPI 1922273879 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WI · 15371-131
4757 N 76TH ST, Milwaukee, WI 53218
Open in Google Maps ↗

Other Identifiers 2

Medicaid39178900-31/048WI
Other15371-131WI · Department Of Regulation & Licensing

Other Providers at the Same Location NPPES 15

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

ST CHARLES YOUTH & FAMILY SERVICES INC
Community/Behavioral Health
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 476-3710
CHARLOTTE MACHALIK
Social Worker (Clinical)
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 539-6999
ST. CHARLES YOUTH & FAMILY SERVICES
Case Management
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 358-4173
GEORGETTE EUGENIA WELLS
Counselor (Mental Health)
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 358-4145
PAMELA MIMS
Counselor (Addiction (Substance Use Disorder))
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 539-6999
ST. CHARLES YOUTH & FAMILY SERVICES, INC.
Case Management
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 476-3710
MRS. KATHLEEN R TOMPKINS APSW OT
Social Worker (Clinical)
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 358-4173
ST. CHARLES
Community/Behavioral Health
4757 N 76TH ST
MILWAUKEE, WI 53218
Milwaukee County (414) 358-4145

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 Charlesetta Jackson's NPI number?

The NPI number for Charlesetta Jackson is 1922273879. It was assigned to this individual provider in the NPPES registry on April 22, 2008.

Where is Charlesetta Jackson located?

Charlesetta Jackson practices at 4757 N 76th St, Milwaukee, WI 53218. The listed phone number is (414) 358-4171.

What is Charlesetta Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Charlesetta Jackson was last updated on April 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.