Lakisha T Ingram, B.A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

168 Greencastle Dr
Jackson, TN 38305

Phone

(731) 614-3572

Fax

(731) 668-0340

NPI assigned

Mar 13, 2017

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2017.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1316488117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 GREENCASTLE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053834",
            "telephone_number": "731-614-3572",
            "fax_number": "731-668-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 GREENCASTLE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-614-3572",
            "fax_number": "731-668-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "LAKISHA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "B.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Integrated Medical Staff of Jackson PC

• All providers in Jackson, TN
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.