KATHY LYNN JACKSON (NPI# 1255689337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255689337 |
| Entity Type | Individual |
| Full Name | KATHY LYNN JACKSON |
| Credential | LPC |
| Practice Address |
7611 Saint Vincent Ave Shreveport LA 71106-4231 |
| Practice Telephone | 3188611671 |
| Practice Fax Number | 3188616529 |
| Mailing Telephone | 3188611671 |
| Mailing Fax Number | 3188616529 |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2012-08-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
3643 | LA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255940391 | Kathy Lorine Jackson | Technician | 2504 Toms Creek Rd, Wayne, WV 25570-9458 | 2020-07-24 |
| 1790175354 | Kathy Jackson | Massage Therapist | 850 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-4903 | 2015-02-03 |
| 1861835860 | Kathy Melton Jackson | Registered Nurse | 6051 Wescott Rd, Columbia, SC 29212-1408 | 2013-04-10 |
| 1619283595 | Kathy L Jackson | Private Vehicle | 15685 N Iron Bridge Rd, Marshall, IL 62441-4663 | 2010-08-30 |
| 1215971379 | Kathy M Jackson | Family Medicine | 502 W Central Ave, La Follette, TN 37766-3400 | 2006-06-16 |
| 1740795285 | Kathy Joy Jackson | Social Worker | 11401 Lorain Ave, Cleveland, OH 44111-5428 | 2017-12-06 |
| 1154728319 | Kathy Lacole Jackson | Public Health or Welfare | 151 E Wood St, Spartanburg, SC 29303-3016 | 2014-12-03 |
| 1104088749 | Kathy Jackson | Physical Therapist | 714 W Grove St, El Dorado, AR 71730-4416 | 2008-06-25 |
| 1306914296 | Kathy Jo Jackson | Pediatrics | 117 W Paterson St, Kalamazoo, MI 49007-2557 | 2006-12-01 |
| 1811060379 | Kathy Jackson | Physical Therapist | 10820 Marvin E. Jones Blvd., Live Oak, FL 32060 | 2006-11-15 |
| Street Address |
7611 SAINT VINCENT AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-4231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336363845 | Melanie G. Petchak | Nurse Practitioner | 7611 Saint Vincent Ave, Shreveport, LA 71106-4231 | 2007-04-13 |
| 1487178315 | David Raines Community Health Center, Inc. | Clinic/Center | 7611 Saint Vincent Ave, Shreveport, LA 71106-4231 | 2017-08-02 |
| 1104198720 | Bridgett Bushnell | Social Worker | 7611 Saint Vincent Ave, Shreveport, LA 71106-4231 | 2012-01-27 |
| 1396924486 | Christus Health Northern Louisiana | Nurse Practitioner | 7611 Saint Vincent Ave, Shreveport, LA 71106-4231 | 2007-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409313 | Divine Behavioral Health, LLC | Counselor | 8870 Youree Dr Ste 105, Shreveport, LA 71115-2512 | 2020-08-25 |
| 1912519083 | Tashara D Williams | Counselor | 3615 Crestview Cir, Shreveport, LA 71119-6522 | 2020-08-20 |
| 1528689213 | Whitfield Counseling Services | Counselor | 2924 Knight St Ste 410, Shreveport, LA 71105-2413 | 2020-05-04 |
| 1376172908 | Lajuana Stephens | Counselor | 7318 Winder Dr, Shreveport, LA 71129-4013 | 2020-04-06 |
| 1417503723 | Beyond The Crossroads Counseling Center, LLC | Counselor | 3321 Youree Dr Ste E, Shreveport, LA 71105-2123 | 2019-08-13 |
| 1336702950 | Terrance Toney Sr. | Counselor | 272 E 78th St, Shreveport, LA 71106-5602 | 2019-04-18 |
| 1922564327 | Briana A Craige | Counselor | 6009 Financial Plz # 102, Shreveport, LA 71129-2615 | 2019-02-11 |
| 1518434182 | Road To Change | Counselor | 2620 Centenary Blvd Ste 204, Shreveport, LA 71104-3350 | 2018-10-31 |
| 1619455649 | Kindled Keys of Counseling, LLC | Counselor | 1737 Boykin Blvd, Shreveport, LA 71107-6108 | 2018-08-01 |
| 1174040646 | Khakillya Babers Everett | Counselor | 8214 Green Leaf Ln, Shreveport, LA 71108-5738 | 2017-08-25 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
Please comment or provide details below to improve the information on KATHY LYNN JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.