Jaqueshia Lafaye Allen

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801113810 Issued in MI

Practice address

3708 Camelot Dr SE Apt 2B
Grand Rapids, MI 49546-6023

Phone

(810) 336-4629

NPI assigned

May 22, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Moka

  • Case Management Agency
  • Wyoming, MI
  • NPI 1992195630
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1093242075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 CAMELOT DR SE APT 2B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466023",
            "telephone_number": "810-336-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 CAMELOT DR SE APT 2B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466023",
            "telephone_number": "810-336-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JAQUESHIA",
        "middle_name": "LAFAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801113810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Lynn Allen, MA LLP CAAC
• Aubrie Allen
• Christina Allen
• Cristapher Allen
• Jamie S Allen, FNP
• Jasmine Demetria Allen
• Kevin Michael Allen, DO
• Nakingi J Allen
• Scott Thomas Allen, MD
• Shayla Yvette Allen

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.