Active NPI
Dana Jackson
- Counselor
- Shreveport, LA
National Provider Identifier
1326582263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2425 Youree Drive
Shreveport, LA 71104 - Phone
- (318) 743-3408
- NPI assigned
- Dec 12, 2016
- Last updated
- Dec 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Social Worker | 104100000X |
Addresses
Primary practice location
2425 Youree Drive
Shreveport, LA 71104
Mailing address
6233 Trailwood Ter
Shreveport, LA 71119-7232
Phone (318) 584-2488
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": "1481500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481500800000",
"number": "1326582263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6233 TRAILWOOD TER",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711197232",
"telephone_number": "318-584-2488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 YOUREE DRIVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71104",
"telephone_number": "318-743-3408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DANA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-12",
"last_updated": "2016-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
}
],
"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 Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.