Individual provider Active NPI

Lisa M Jackson, PLPC

  • Professional Counselor
  • Natchitoches, LA
National Provider Identifier
1184076630
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7749 Issued in LA
Practice address
210 Medical Dr
Natchitoches, LA 71457-6052
Phone
(318) 357-3122
NPI assigned
Jul 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X 7749 LA Primary

Addresses

Primary practice location

210 Medical Dr
Natchitoches, LA 71457-6052

Mailing address

408 John Watley Rd
Natchitoches, LA 71457-7021
Phone (318) 332-3502

Other practice location 1

265 Highland Dr
Many, LA 71449-3717
Phone (318) 256-4206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116001088 LA Practitioner - Mental Health Counselor 8921456906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1310 N Hearne Ave
Shreveport, LA 71107-6516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Be Inspired Counseling & Consulting LLC CurrentSince Apr 29, 2024 Accepting new patients

Locations

304 University Pkwy
Natchitoches, LA 71457
Phone 31822670212

2220 Shreveport Hwy
Pineville, LA 71360
Phone (318) 266-7021

Organizations & group practices 1

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1184076630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 JOHN WATLEY RD",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714577021",
            "telephone_number": "318-332-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MEDICAL DR",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576052",
            "telephone_number": "318-357-3122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Many",
            "state": "LA",
            "postal_code": "714493717",
            "country_code": "US",
            "telephone_number": "318-256-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2022-04-29",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "7749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

Verify at the official NPI Registry.