Tonya Sue Jackson, PH.D.

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

1072 Issued in LA

Practice address

5411 Coliseum Blvd
Alexandria, LA 71303-3729

Phone

(318) 484-2347

NPI assigned

Apr 15, 2010

Last updated

Dec 14, 2021By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Central la Human Services District

  dba Caring Choices

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alexandria, LA
  • NPI 1033543756
  Medicare reassignment NPD
• Central la Human Services District

  dba Caring Choices

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marksville, LA
  • NPI 1740614338
  NPD

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1255657243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3770 MONROE HIGHWAY STE C",
            "address_2": "PMB 170",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604170",
            "telephone_number": "318-880-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 COLISEUM BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033729",
            "telephone_number": "318-484-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TONYA",
        "middle_name": "SUE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "LA",
            "license": "1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph Dudley Jackson III, D.D.S.
• Rita Jackson, RSW
• Ronnie Jackson
• Shadiamond Jackson
• Terrence Terrell Jackson
• Billyona Jacobs, MHS
• Felicia Yaquita Jacobs, MHT
• Naseem A Jaffrani, M.D.
• James a. White, III, M.D., Apmc
• James P. David, M.D., a Professional Corporation (Vascular Clinic)

• Intellectual & Developmental Disabilities Psychologist in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Intellectual & Developmental Disabilities Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.