Individual provider Active NPI

Tiffany Williams Jamerson

  • Mental Health Counselor
  • Shreveport, LA
National Provider Identifier
1124577093
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2715 Mackey PL
Shreveport, LA 71118-2544
Phone
(318) 220-8423
Fax
(318) 220-8573
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2715 Mackey PL
Shreveport, LA 71118-2544

Mailing address

2715 Mackey PL
Shreveport, LA 71118-2544
Phone (318) 220-8423

Other practice location 1

7505 Pines Rd Ste 1115
Shreveport, LA 71129-3900
Phone (318) 683-4086

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

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1124577093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 MACKEY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182544",
            "telephone_number": "318-220-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 MACKEY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182544",
            "telephone_number": "318-220-8423",
            "fax_number": "318-220-8573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7505 Pines Rd Ste 1115",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711293900",
            "country_code": "US",
            "telephone_number": "318-683-4086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMERSON",
        "first_name": "TIFFANY",
        "middle_name": "WILLIAMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.