JACQUELINE WILSON (NPI# 1457852014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457852014 |
| Entity Type | Individual |
| Full Name | JACQUELINE WILSON |
| Credential | LCSW |
| Practice Address |
2219 Claiborne Ave Shreveport LA 71103-4301 |
| Mailing Address |
9017 Moray Dr Shreveport LA 71129-5127 |
| Practice Telephone | 3187790434 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2020-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
10252 | LA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687791 | Jacqueline Latia Wilson | Nurse Practitioner | 225 N Clifton Ave, Louisville, KY 40206-2496 | 2019-09-08 |
| 1790186393 | Jacqueline Wilson | Nurse Practitioner | 1101 Highway 76 Ste A, Clarksville, TN 37043-2420 | 2014-09-15 |
| 1295022622 | Jacqueline A. Wilson | Contractor | 12257 Middlebrook Sq, San Diego, CA 92128-3759 | 2011-07-06 |
| 1225244692 | Jacqueline Golden Wilson | Occupational Therapist | 15115 Eastview Dr, Upperco, MD 21155-9746 | 2007-05-15 |
| 1942373212 | Jacqueline Wilson | Counselor | 6 Cabot Pl Ste 6, Stoughton, MA 02072-4625 | 2006-11-16 |
| 1154951556 | Jacqueline Anne Wilson | Nurse Practitioner | 640 S 19th St Ste 100, Nevada, IA 50201-2902 | 2020-01-24 |
| 1457909830 | Jacqueline Lois Reagor Wilson | Speech-Language Pathologist | 9285 Medical Plaza Dr, Charleston, SC 29406-9126 | 2019-08-29 |
| 1245735943 | Jacqueline Wilson | Nurse Practitioner | 284 Highway 641 N, Camden, TN 38320-1350 | 2018-03-26 |
| 1801348636 | Jacqueline Sue Wilson | Physical Therapist | 901 N Porter Ave, Norman, OK 73071-6404 | 2016-10-27 |
| 1487102687 | Jacqueline Maureen Wilson | Counselor | 221 Avenue B, Snohomish, WA 98290-2840 | 2016-09-15 |
| Street Address |
2219 CLAIBORNE AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679797286 | Armanda Y. Whitaker I | Counselor | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2007-04-13 |
| 1134727704 | Ida Natasha Henderson | Case Manager/Care Coordinator | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2020-10-15 |
| 1770100851 | Courtney Ukpabi | Case Manager/Care Coordinator | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2020-07-06 |
| 1730713587 | Peggy B Mahoney-clark | Case Manager/Care Coordinator | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2020-03-01 |
| 1396208088 | Kulicia Anderson | Case Manager/Care Coordinator | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2019-04-09 |
| 1194294660 | Lisa Jones Battle | Case Manager/Care Coordinator | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2018-11-14 |
| 1679051957 | Tasha Simpson | Social Worker | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2018-07-30 |
| 1861978736 | Jutina Latson-cole | Social Worker | 2219 Claiborne Ave, Shreveport, LA 71103 | 2018-07-13 |
| 1407341746 | Shakisha Moore | Social Worker | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2018-06-28 |
| 1417401506 | John Lawayne Taylor Jr. | Counselor | 2219 Claiborne Ave, Shreveport, LA 71103 | 2016-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568083293 | Mickey Dawnell Lathon | Social Worker | 8823 Chadwick Dr, Shreveport, LA 71129-5124 | 2020-05-05 |
| 1649818303 | Jacinta Tiane Lafleur | Social Worker | 9806 Kingston Rd, Shreveport, LA 71118-5320 | 2019-12-12 |
| 1619537651 | The Therapeutic & Restorative Village | Social Worker | 820 Jordan St Ste 315c, Shreveport, LA 71101-4512 | 2019-06-20 |
| 1700365996 | Turning Point Counseling Services LLC | Social Worker | 234 Mayo Rd, Shreveport, LA 71106-7916 | 2018-08-09 |
| 1528546983 | Lisa Haulmark | Social Worker | 2350 Levy St, Shreveport, LA 71103-3656 | 2018-07-29 |
| 1134625932 | Nikkole Weiss | Social Worker | 3000 Knight St Bldg 5, Shreveport, LA 71105-2566 | 2018-04-02 |
| 1659875219 | Tammi Layne Rider | Social Worker | 4859 Dixie Garden Loop, Shreveport, LA 71105-4035 | 2018-03-20 |
| 1679088355 | Takandra A Johnson | Social Worker | 8700 Millicent Way Apt 605, Shreveport, LA 71115-2254 | 2017-12-04 |
| 1801347232 | James Ross Sr. | Social Worker | 1010 Creswell Ave, Shreveport, LA 71101-3918 | 2016-10-20 |
| 1558713438 | Angela White | Social Worker | 9315 Midvale Dr, Shreveport, LA 71118-3554 | 2016-07-05 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
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| 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.