MRS. WEALTHIA LYNA JACKSON (NPI# 1811412448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811412448 |
| Entity Type | Individual |
| Full Name | MRS. WEALTHIA LYNA JACKSON |
| Credential | LICENSED SCHOOL PSYC |
| Practice Address |
11115 Sandwood Dr Keithville LA 71047-8345 |
| Practice Telephone | (318) 393-6935 |
| Mailing Telephone | 3183936935 |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
LSSP009 | LA | Behavioral Health & Social Service Providers |
| Street Address |
11115 SANDWOOD DR |
| City | KEITHVILLE |
| State | LA |
| Zip Code | 71047-8345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336752450 | Sweetpee Care Services | Technician | 11111 Ivory Ln, Keithville, LA 71047 | 2020-08-28 |
| 1114452349 | Morgan King | Counselor | 11096 Domino Dr, Keithville, LA 71047 | 2017-04-25 |
| 1104364611 | Nakeela Lane | Counselor | 10158 English Oaks Dr, Keithville, LA 71047 | 2017-02-03 |
| 1952771628 | Darryl Morgan | Counselor | 11712 Timber Ridge Dr, Keithville, LA 71047 | 2015-10-06 |
| 1487888293 | Lacam Enterprise LLC | Durable Medical Equipment & Medical Supplies | 5258 Danton Place, Keithville, LA 71047 | 2009-05-07 |
| 1508949686 | Caddo Parish Fire District No. Six | Ambulance | 11450 Old Mansfield Road, Keithville, LA 71047 | 2006-10-23 |
| 1679019699 | Sara Smith | Registered Nurse | 9691 Rosalie Loop, Keithville, LA 71047-6108 | 2017-01-13 |
| 1427583632 | Sherlynn Hall | Non-emergency Medical Transport (VAN) | 12275 Johns Gin Rd, Keithville, LA 71047-6161 | 2017-04-25 |
| 1669762332 | Triplej Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9155 Springridge Tx Stln Rd, Keithville, LA 71047-6192 | 2011-04-14 |
| 1497234660 | Robert Lewis Smith | Nuclear Medicine | 11398 Morton Rd, Keithville, LA 71047-6529 | 2018-08-08 |
| Find all providers in zip 71047 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285148551 | Shanette Louise Dominick | Psychologist | 702 Highland View Dr, Youngsville, LA 70592-6185 | 2017-11-25 |
| 1073039566 | Lynette Rolland | Psychologist | 5862 Sylvia Dr, New Orleans, LA 70124-1132 | 2017-08-17 |
| 1447780382 | Latasha M Cubas | Psychologist | 128 Oakmont Dr, La Place, LA 70068-1730 | 2017-06-14 |
| 1528417045 | Mandi Gaubert Bonvillain | Psychologist | 1018 Verrett Street, Houma, LA 70360 | 2016-06-06 |
| 1679952469 | W Alan Coulter | Psychologist | 1900 Gravier, 6th Floor, New Orleans, LA 70112 | 2015-05-26 |
| 1982098943 | Assessment & Psychological Services, Inc | Psychologist | 4300 S I 10 Service Rd W Ste 112, Metairie, LA 70001-7425 | 2015-03-26 |
| 1447673942 | Miriam Carroll Crumby Kimball | Psychologist | 29816 Aster St, Walker, LA 70785-7929 | 2014-02-04 |
| 1811319239 | Damon B. Smothers | Psychologist | 12100 Morrison Rd, New Orleans, LA 70128-2418 | 2014-01-21 |
| 1376979781 | Tobi Moore Provenzano | Psychologist | 8501 Manhattan, Harvey, LA 70058 | 2013-09-17 |
| 1982996054 | Barbara Jean Cottingham | Psychologist | 6728 Kinloch St, Winnsboro, LA 71295-2618 | 2011-05-09 |
| Find all providers with the same taxonomy | ||||
| City | KEITHVILLE |
| Zip Code | 71047 |
Please comment or provide details below to improve the information on MRS. WEALTHIA LYNA 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.