Shadiamond Jackson
Individual provider Active NPI Social Worker · Alexandria, LA
NPI 1861864548 · NPPES record last updated Oct 21, 2015
Key facts
- NPI
- 1861864548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 5413 Downing St Apt 1G
Alexandria, LA 71301-3117 - Phone
- (318) 557-9565
- NPI assigned
- Oct 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
5413 Downing St Apt 1G
Alexandria, LA 71301-3117
Mailing address
5413 Downing St Apt 1G
Alexandria, LA 71301-3117
Phone (318) 557-9565
Other providers in Alexandria, LA
- Laquandra Jackson
- Racine Dominique Jackson
- Ralph Dudley Jackson III
- Rita Jackson
- Ronnie Jackson
- Terrence Terrell Jackson
- Tonya Sue Jackson
- Billyona Jacobs
- Felicia Yaquita Jacobs
- Naseem A Jaffrani
All providers in Alexandria, LA · Social Worker in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2015. 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.