EBONY JACKSON (NPI# 1871022699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871022699 |
| Entity Type | Individual |
| Full Name | EBONY JACKSON |
| Practice Address |
3084 Westfork Dr Ste C Baton Rouge LA 70816-2254 |
| Practice Telephone | 2252966083 |
| Mailing Telephone | 2252966083 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2019-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3233 S Sherwood Forest Blvd Ste 204, Baton Rouge, LA 708162250 | (225) 302-5804 | 2253025825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749597 | Ebony Jackson | Counselor | 11510 Homestead Rd Ste 295, Houston, TX 77016-1237 | 2020-10-27 |
| 1164073334 | Ebony Jackson | Pharmacy Technician | 145 Emanuel Farm Rd Lot 77, Brunswick, GA 31525-2469 | 2019-09-27 |
| 1750848800 | Ebony Jackson | Doula | 12158 Alexandra Dr, Jacksonville, FL 32218-8883 | 2019-02-25 |
| 1699094326 | Ebony Marie Jackson | Licensed Practical Nurse | 39 Dunbar St, Rochester, NY 14619-2142 | 2010-05-20 |
| 1356678197 | Ebony Jackson | Licensed Practical Nurse | 4754 E 175th St, Cleveland, OH 44128-3932 | 2009-11-16 |
| 1225636582 | Ebony Jamice Jackson | Registered Nurse | 3601 Shady Timber Dr, Twinsburg, OH 44087-4945 | 2020-10-09 |
| 1568025807 | Ebony Jackson | Social Worker | 1655 Burlington Pike Ste 101, Florence, KY 41042-4909 | 2019-04-22 |
| 1639681331 | Ebony Craig Jackson | Pharmacist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2017-11-02 |
| 1477904357 | Ebony Jackson | Counselor | 2275 Arlington Dr, San Leandro, CA 94578-1132 | 2016-06-22 |
| 1730564279 | Ebony Conerly Jackson | Social Worker | 23791 Southpoint Dr, Denham Springs, LA 70726-6856 | 2015-07-27 |
| Street Address |
3084 WESTFORK DR STE C |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70816-2254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053863472 | Victoria Morgan | Counselor | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2016-11-02 |
| 1760098297 | Crystal Randolph | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-09-21 |
| 1578171922 | Gabriel Margaret Reynolds | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-07-21 |
| 1740898485 | John Edward Cherif Guillot | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-07-20 |
| 1508494899 | Bailey Noel Clary | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-03-31 |
| 1003444639 | Nicole Collins | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-03-30 |
| 1215564869 | Tisha Ealy Sanders | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-03-24 |
| 1700412079 | Sarah E Lanzetta | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-03-19 |
| 1235765603 | Sarena M Evans-hutchins | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-03-18 |
| 1164052759 | John Pierre Lafleur | Case Manager/Care Coordinator | 3084 Westfork Dr Ste C, Baton Rouge, LA 70816-2254 | 2020-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475128 | Exceptional Dental of Coursey, LLC | Dentist | 12045 Coursey Bvld., Baton Rouge, LA 70816 | 2020-10-26 |
| 1780294058 | Yolande Eileen Thomas | Case Manager/Care Coordinator | Array of Hope, 11940 Bricksome Ave, Baton Rouge, LA 70816 | 2020-08-03 |
| 1164052296 | Hoh Palliative Care, LLC | Family Medicine | 4212 American Way, Suite C, Baton Rouge, LA 70816 | 2020-01-16 |
| 1427698778 | Patricia Salton-hobson | Case Manager/Care Coordinator | 3888 S. Sherwood Forest Blvd Bldg II Ste F, Baton Rouge, LA 70816 | 2020-01-14 |
| 1467010447 | Niqueria Von'shea Mcswain | Licensed Practical Nurse | 2455 Weldwood Dr, Apt 6108, Baton Rouge, LA 70816 | 2019-06-04 |
| 1184184665 | Brent C Underwood | Chiropractor | 11851 Coursey Blvd., Baton Rouge, LA 70816 | 2019-03-21 |
| 1720544240 | Titus Randle II | Secured Medical Transport (VAN) | 1234 Pompey Dr, Baton Rouge, LA 70816 | 2019-02-20 |
| 1356820054 | Ashley Wheeler | Social Worker | 1761 Physicians Blvd., Baton Rouge, LA 70816 | 2018-08-13 |
| 1609355783 | Lynda W Thibodeaux | Counselor | 4021 W.e. Heck Court, Building B Suite 2, Baton Rouge, LA 70816 | 2018-08-09 |
| 1083193114 | Akamin Victor Nkengaka | Case Manager/Care Coordinator | Pelican Bayou Counseling Services, 3084 Westfolk Drive, Baton Rouge, LA 70816 | 2018-08-09 |
| Find all providers in zip 70816 | ||||
| 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 |
|---|---|---|---|---|
| 1992305023 | Deonna Hawkins Jackson | Case Manager/Care Coordinator | 17616 Heritage Estates Dr, Baton Rouge, LA 70810-6579 | 2020-10-28 |
| 1306445713 | Beverly Jean Holmes | Case Manager/Care Coordinator | 9331 Foster Rd Apt C, Baton Rouge, LA 70811-2736 | 2020-10-19 |
| 1922606326 | Christie Hitchens | Case Manager/Care Coordinator | 1041 Chariot Dr, Baton Rouge, LA 70816-1842 | 2020-10-16 |
| 1750989190 | Bridgette Lynette Azoanee | Case Manager/Care Coordinator | 4119 Lake Sherwood Ave E, Baton Rouge, LA 70816-7322 | 2020-10-16 |
| 1629676465 | Jessica Dennis | Case Manager/Care Coordinator | 2950 Chippewa St, Baton Rouge, LA 70805-8126 | 2020-10-14 |
| 1720686769 | Wyona Jordan | Case Manager/Care Coordinator | 6980 Saint Francis Ave, Baton Rouge, LA 70811-1419 | 2020-10-13 |
| 1659984748 | Lasondra Finley | Case Manager/Care Coordinator | 6024 N Howell Dr, Baton Rouge, LA 70805-7231 | 2020-08-28 |
| 1134730476 | Melissa Urch | Case Manager/Care Coordinator | 14635 S Harrells Ferry Rd Ste 3a, Baton Rouge, LA 70816-2960 | 2020-08-11 |
| 1780294058 | Yolande Eileen Thomas | Case Manager/Care Coordinator | Array of Hope, 11940 Bricksome Ave, Baton Rouge, LA 70816 | 2020-08-03 |
| 1285243691 | Adriana Arshell Vessell | Case Manager/Care Coordinator | 2211 Weymouth Dr, Baton Rouge, LA 70809-2017 | 2020-07-31 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70816 |
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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.