Latosha M Jackson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2138 Issued in NH

Practice address

6 Chenell Dr Ste 100
Concord, NH 03301-8514

Phone

(402) 469-6899

NPI assigned

Jun 17, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Latosha M Duester Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Latosha Jackson LLC

  • Community/Behavioral Health Agency
  • Concord, NH
  • NPI 1518618354
  NPD Authorized official
• Latosha Jackson

  • Case Management Agency
  • Lincoln, NE
  • NPI 1871055129
  NPD Authorized official

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1477992188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARDY RD # 128",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031104915",
            "telephone_number": "402-469-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CHENELL DR STE 100",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033018514",
            "telephone_number": "402-469-6899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Wall St",
            "address_2": "Ste 400",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "03101",
            "country_code": "US",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LATOSHA",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2108",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1822",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATOSHA",
            "last_name": "DUESTER",
            "middle_name": "M",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cosmin D Ionescu, MD
• Ann E Isenberg, PHD
• Suzy A. Iverson, D.O.
• Diane Jane Jackson, OTR
• Gabbrielle Jackson, MS, CNS
• Thomas Lane Jackson, MD
• Sarah Caitlyn Jacoby, PA-C
• Beth Ann Jacques, AU.D., CCC-A
• Randal F Jacunski, MHS,LADC
• Andrew M Jaffe, MD

• Clinical Social Worker in Concord, NH
• Providers in Concord, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.