THAD JACKSON (NPI# 1669988879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669988879 |
| Entity Type | Individual |
| Full Name | THAD JACKSON |
| Practice Address |
449 Ben Hur Rd Apt 5106b Baton Rouge LA 70820-4144 |
| Practice Telephone | 5044101976 |
| Mailing Telephone | 5044101976 |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 00000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134177108 | Thad Jackson | Neurological Surgery | 1700 Ring Rd, Elizabethtown, KY 42701-9497 | 2006-05-04 |
| 1891782421 | Thad M Jackson | Family Medicine | 1010 W North Down River Rd, Grayling, MI 49738-2060 | 2005-09-29 |
| Street Address |
449 BEN HUR RD APT 5106B |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70820-4144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285942 | Lucas Patin | Specialist/Technologist | 449 Ben Hur Rd., Apt. 4311, Baton Rouge, LA 70820 | 2018-12-03 |
| 1851882302 | Khourtni Rose Fears | Counselor | 1134 W Lee Dr Apt B, Baton Rouge, LA 70820 | 2018-05-21 |
| 1013405646 | St Gabriel Health Clinic, Inc | Clinic/Center | 7800 Innovation Dr, Baton Rouge, LA 70820 | 2018-04-30 |
| 1972965325 | Reginald Knox | Non-emergency Medical Transport (VAN) | 1481 Lila Street, Baton Rouge, LA 70820 | 2016-03-24 |
| 1124480058 | Asha Marie Vyas | Counselor | 4000 Lake Beau Pre Blvd Apt 66, Baton Rouge, LA 70820 | 2016-03-21 |
| 1316317449 | Connor Alleman | Student in an Organized Health Care Education/Training Program | 1984 Brightside Dr. Apt#215, Baton Rouge, LA 70820 | 2015-10-01 |
| 1699151456 | Lynn Dirks | Physical Therapist | 6307 Hope Estate Dr, Baton Rouge, LA 70820 | 2015-08-04 |
| 1609258839 | Emily Heitman | Student in an Organized Health Care Education/Training Program | 2819 Three Oaks Avenue, Baton Rouge, LA 70820 | 2015-06-24 |
| 1811397854 | Maria E Garcia-giese | Speech-Language Pathologist | 6040 Belle Grove Dr, Baton Rouge, LA 70820 | 2014-08-27 |
| 1740606763 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9326 Burbank Dr, Baton Rouge, LA 70820 | 2014-03-14 |
| Find all providers in zip 70820 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840444 | Bradford J Williams | Counselor | 624 S 16th St, Baton Rouge, LA 70802-4011 | 2020-10-28 |
| 1255947883 | Vanessa Brown | Counselor | 12438 Lockhaven Ave, Baton Rouge, LA 70815-6537 | 2020-09-18 |
| 1588287809 | Catherine Vicknair | Counselor | 8755 Sullivan Rd Ste 3a, Baton Rouge, LA 70818-6031 | 2020-05-20 |
| 1174144596 | Feleshia N Borskey Young | Counselor | 3940 Prescott Rd Ste A, Baton Rouge, LA 70805-5143 | 2020-04-27 |
| 1396208617 | Trinette Amelia Jackson | Counselor | 4336 North Blvd Ste 104, Baton Rouge, LA 70806-3920 | 2019-04-12 |
| 1639632169 | Ezekiel Alsander | Counselor | 6929 Commerce Cir Apt 6101, Baton Rouge, LA 70809-1887 | 2019-04-11 |
| 1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
| 1386101764 | Joseph Stevenson | Counselor | 6245 Cedar Grove Dr, Baton Rouge, LA 70812-1730 | 2019-02-21 |
| 1891252276 | Laketa Smith | Counselor | 8365 Siegen Ln Apt 4, Baton Rouge, LA 70810-1901 | 2019-02-21 |
| 1083170500 | Lashona Latrice Alexander | Counselor | 4845 Jamestown Ave Ste 208, Baton Rouge, LA 70808-3248 | 2019-02-20 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70820 |
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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.