Jaclyn Denise Brooks, MHS
Individual provider Active NPI Case Manager/Care Coordinator · Leesville, LA
NPI 1881189488 · NPPES record last updated Apr 3, 2025
Key facts
- NPI
- 1881189488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1112 Nolan Trce # B
Leesville, LA 71446-3838 - Phone
- (337) 404-7131
- NPI assigned
- Jun 26, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairway Counseling Agency, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1112 Nolan Trce # B
Leesville, LA 71446-3838
Mailing address
1112 Nolan Trce Ste B
Leesville, LA 71446-3838
Phone (318) 404-7731
Other practice location 1
710 Versailles Blvd
Alexandria, LA 71303-2351
Phone (318) 449-4474
Other providers in Leesville, LA
- Sarah Kathleen Brack
- Charlotte Brady
- Edwin Brennan
- Brentwood Acquisition-Shreveport Inc.
- Kaitlyn P Briscoe
- Jeana Marie Brooks
- Jacob Steven Broussard
- Amanda Kyle Brown
- Brittany Dawn-Bonton Brown
- Hope Renee Brown
All providers in Leesville, LA · Case Manager/Care Coordinator in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2025. 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.