Leslie Jackson-Vallade, LDN

Primary specialty

NutritionistTaxonomy code 133N00000X

License

DX5990 Issued in MD

Practice address

3851 Pentland Hills Dr
Upper Marlboro, MD 20774-9242

Phone

(443) 519-9388

NPI assigned

Mar 6, 2023

Last updated

May 20, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Alpha Wellness, LLC

  dba Alpha Wellness

  • Registered Dietitian
  • Upper Marlboro, MD
  • NPI 1609643915
  Authorized official Same address or phone

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1457051898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 PENTLAND HILLS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749242",
            "telephone_number": "443-519-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 PENTLAND HILLS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749242",
            "telephone_number": "443-519-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-VALLADE",
        "first_name": "LESLIE",
        "credential": "LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX5990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisha M Ivey-Nixon, LCSW-C
• Eunice Iwuchukwu
• Izzy Transport LLC
• Musa Jabbie
• Maranda C Jackson-Parkin, CRNP-BC
• Andria Jackson
• Arielle M Jackson, RMP
• Ayana Beatrice Jackson
• Bettina Monet Jackson, MS CCC-SLP
• Candace Jackson

• Nutritionist in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Nutritionist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.