NPIMap

Individual provider Active NPI

Latanya Jackson, MSW, RSW

  • Case Manager/Care Coordinator
  • Marrero, LA
National Provider Identifier
1104296367
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1609 Haydel Dr
Marrero, LA 70072-3532
Phone
(504) 813-6690
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7789 LA
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

1609 Haydel Dr
Marrero, LA 70072-3532

Mailing address

1609 Haydel Dr
Marrero, LA 70072-3532
Phone (504) 813-6690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7789LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Community Health Care Centers, Inc Past Accepting new patients
Jefferson Community Health Care Centers, Inc. Past Accepting new patients
Jefferson Community Health Care Centers Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1104296367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 HAYDEL DR",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723532",
            "telephone_number": "504-813-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 HAYDEL DR",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723532",
            "telephone_number": "504-813-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LATANYA",
        "name_prefix": "Miss",
        "credential": "MSW, RSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "7789",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.