JACQUELLE JACKSON (NPI# 1316394141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316394141 |
| Entity Type | Individual |
| Full Name | JACQUELLE JACKSON |
| Practice Address |
331 Milam St Shreveport LA 71101 |
| Mailing Address |
9730 Baird Rd Apt 2310 Shreveport LA 71118-3879 |
| Practice Telephone | 3182130904 |
| Mailing Telephone | 3185602311 |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2018-11-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
331 MILAM ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003958760 | Interim Healthcare Staffing of North La., Inc. | Home Health | 331 Milam St, Suite 200, Shreveport, LA 71101-5353 | 2007-02-12 |
| 1124643606 | Exceptional Wellness of Louisiana Incorporated | Community/Behavioral Health | 331 Milam St, Shreveport, LA 71101-5353 | 2020-06-10 |
| 1881043552 | Phyllis Lewis | Counselor | 331 Milam St, Shreveport, LA 71101-5353 | 2016-06-03 |
| 1588012785 | Roslyn Carter | Counselor | 331 Milam St, Shreveport, LA 71101-5353 | 2016-05-27 |
| 1366890568 | Eric Tramiel | Counselor | 331 Milam St, Shreveport, LA 71101-5353 | 2016-05-27 |
| 1831547033 | Pamela Harris-waller | Counselor | 331 Milam St, Shreveport, LA 71101-5353 | 2016-05-27 |
| 1558719757 | Courtney Smith | Counselor | 331 Milam St, Shreveport, LA 71101 | 2016-05-27 |
| 1790132520 | Ivory Williams | Counselor | 331 Milam St, Shreveport, LA 71101-5353 | 2016-05-23 |
| 1528415353 | Lenard Adams | Counselor | 331 Milam St, Shreveport, LA 71101-5353 | 2016-05-23 |
| 1245687169 | Adria Johnson | Counselor | 331 Milam St, Shreveport, LA 71101-5353 | 2016-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360887 | Halena Jones | Case Manager/Care Coordinator | 9409 Chaparral Ln, Shreveport, LA 71118-4337 | 2020-09-11 |
| 1598376196 | Michaela Nicole Bradley | Case Manager/Care Coordinator | 10021 Stratmore Cir, Shreveport, LA 71115-3416 | 2020-08-17 |
| 1619585791 | Kimberly Bissell | Case Manager/Care Coordinator | 7505 Pines Rd Ste 1115, Shreveport, LA 71129-3900 | 2020-07-15 |
| 1902414170 | Unique Lashae Lister | Case Manager/Care Coordinator | 2611 Corbitt St, Shreveport, LA 71108-2805 | 2020-07-14 |
| 1407474828 | Angela Harris | Case Manager/Care Coordinator | 1111 W 70th St Apt 93, Shreveport, LA 71106-3558 | 2020-07-13 |
| 1669096921 | Ryan Barham | Case Manager/Care Coordinator | 824 Oneonta St, Shreveport, LA 71106-1130 | 2020-06-02 |
| 1922621085 | Julian White | Case Manager/Care Coordinator | 8529 Grover Pl, Shreveport, LA 71115-2707 | 2020-05-24 |
| 1396368817 | Shannon Marie Cannon | Case Manager/Care Coordinator | 1543 Summers St, Shreveport, LA 71108-3131 | 2020-05-19 |
| 1730701954 | Brianna Mason | Case Manager/Care Coordinator | 1533 Marshall St, Shreveport, LA 71101-3941 | 2020-05-11 |
| 1295355238 | Angela Rice | Case Manager/Care Coordinator | 2704 Frostwood Dr, Shreveport, LA 71108-5524 | 2020-04-20 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on JACQUELLE 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.