Jacqueline Michel Whitmore, GSW
Individual provider Active NPI Social Worker · Jackson, LA
NPI 1790995124 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1790995124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6729 (LA)
- Practice address
- 4502 Hwy.10
Jackson, LA 70748-0498 - Phone
- (225) 634-0224
- Fax
- (225) 634-0213
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6729 | LA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6729 | LA | Yes |
Addresses
Primary practice location
4502 Hwy.10
Jackson, LA 70748-0498
Mailing address
PO Box 498
Jackson, LA 70748-0498
Phone (225) 634-0224
Other providers in Jackson, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.