EBONY C JACKSON LLC


Address: 23791 Southpoint Dr, Denham Springs, LA 70726-6856
Phone: 2253692617

EBONY C JACKSON LLC (NPI# 1821470188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821470188
Entity Type Organization
Organization Name EBONY C JACKSON LLC
Practice Address 23791 Southpoint Dr
Denham Springs
LA 70726-6856
Practice Telephone 2253692617
Mailing Telephone 2253692617
Enumeration Date 2015-06-23
Last Update Date 2015-06-23
Authorized Official Name MISS EBONY CONERLY JACKSON (SOCIAL WORKER)
Authorized Official Telephone 2252846249
Authorized Official Credential LCSW, BACS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
9158 LA Ambulatory Health Care Facilities

Office Location

Street Address 23791 SOUTHPOINT DR
City DENHAM SPRINGS
State LA
Zip Code 70726-6856

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730564279 Ebony Conerly Jackson Social Worker 23791 Southpoint Dr, Denham Springs, LA 70726-6856 2015-07-27

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NPI Name Taxonomy Address Enumeration
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1306456231 Jinci Strahan Registered Nurse 24495 La-16, Denham Springs, LA 70726 2020-08-05
1568085058 Bailey Brumley Case Manager/Care Coordinator 106 Business Park Ave, Denham Springs, LA 70726 2020-05-19
1518527977 Papa's Farmacia Via Luzianna LLC Pharmacy 25831 Walker South Rd Ste 1, Denham Springs, LA 70726 2019-06-18
1265995807 Michael Jacob Efferson Counselor 303 Veteran Blvd, Denham Springs, LA 70726 2019-04-10
1477031524 Melissa Sepeda Social Worker 1110 South Range Ave, Denham Springs, LA 70726 2018-07-31
1215420633 Tiffany Summers Counselor 30826 Linder Road, Denham Springs, LA 70726 2018-06-11
1588194377 Kenneth Joseph Williams Counselor 26055 Burlwood Ave., Denham Springs, LA 70726 2017-06-14
1780130369 Bonnie Pettyjohn Counselor 25560 Oak Hill Rd, Denham Springs, LA 70726 2016-09-01
1053769794 Southeast Community Health Systems Clinic/Center 25753 Walker Road South, Denham Springs, LA 70726 2016-06-02
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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

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1033682802 Genesis Specialty Groups, LLC Clinic/Center 778 Chevelle Drive, Baton Rouge, LA 70806 2019-01-04
1669997698 Fleur Des Maisons Clinic/Center 2223 Franklin Ave, New Orleans, LA 70117-6929 2017-08-10
1285093922 Live Oak Behavioral Health Group, L.L.C. Clinic/Center 7084 Cemetary Hwy, At Live Oak Landing, Saint Martinville, LA 70582-7900 2016-02-22
1598135535 Abundant Care Center Clinic/Center 12855 Castle Hill Dr, Baton Rouge, LA 70814-7426 2015-10-02
1598180275 Peep Inc. Clinic/Center 1411 Orange St, Monroe, LA 71202-2323 2014-03-04
1093092694 H & B Caring Clinic/Center 1009 Clara St, Jennings, LA 70546-5129 2011-11-10
1821225996 Emerson Centre, Inc. Clinic/Center 301 E Alabama Ave, Ruston, LA 71270-3981 2009-06-16
1992950828 Metropolitan Circles, LLC Clinic/Center 90 Melrose Ave, Natchitoches, LA 71457-5926 2008-11-19
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Competitor

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City DENHAM SPRINGS
Zip Code 70726

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Dataset Information

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.

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