Lawana Jackson Mabry, LCSW-BACS
Individual provider Active NPI Clinical Social Worker · Greenwell Springs, LA
NPI 1255749487 · NPPES record last updated Nov 7, 2022
Key facts
- NPI
- 1255749487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 10286 (LA)
- Practice address
- 10632 Holly Hock Dr
Greenwell Springs, LA 70739-5312 - Phone
- (985) 241-1924
- Fax
- (985) 616-1023
- NPI assigned
- Jul 31, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA, MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260608002367 | LA | Practitioner - Clinical Social Worker | 2769953033 | Reassigns benefits to 1 organization |
| I20260608003129 | MS | Practitioner - Clinical Social Worker | 2769953033 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10286 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restore Outreach Transportation, LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10286 | LA | Yes |
Addresses
Primary practice location
10632 Holly Hock Dr
Greenwell Springs, LA 70739-5312
Mailing address
10632 Holly Hock Dr
Greenwell Springs, LA 70739-5312
Phone (985) 241-1924
Other names
- Lawana Michelle Jackson
Other providers in Greenwell Springs, LA
- Edward Linden Jr.
- Christen Keller Linton
- Menley Rae Long
- Louisiana Cni, LLC
- Chasity Lovely
- Anna Amelia Major
- Amanda Catherine Manuel
- Vanessa Martin
- Sheri McGowan
- Stephanie McMichael
All providers in Greenwell Springs, LA · Clinical Social Worker in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.