Active NPI
Travion Jackson
- Case Manager/Care Coordinator
- Monroe, LA
National Provider Identifier
1881339273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 5423
- Practice address
- 645 Highway 80 E
Monroe, LA 71203-8527 - Phone
- (318) 343-8744
- Fax
- (318) 345-7123
- NPI assigned
- May 1, 2022
- Last updated
- Apr 20, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 5423 | LA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 012121095 | LA |
Addresses
Primary practice location
645 Highway 80 E
Monroe, LA 71203-8527
Mailing address
1700 Lake St
Lake Providence, LA 71254-5208
Phone (318) 341-8147
Other practice location 1
1700 Lake St
Lake Providence, LA 71254-5208
Phone (318) 341-8147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012121095 | LA | MD | Addiction (Substance Use Disorder) Counselor |
| 5423 | LA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Living Water Ministries International | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Living Water Family Services
- Community/Behavioral Health Agency
- Monroe, LA
- NPI 1972980514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776643200000",
"number": "1881339273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 LAKE ST",
"city": "LAKE PROVIDENCE",
"state": "LA",
"postal_code": "712545208",
"telephone_number": "318-341-8147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 HIGHWAY 80 E",
"city": "MONROE",
"state": "LA",
"postal_code": "712038527",
"telephone_number": "318-343-8744",
"fax_number": "318-345-7123"
}
],
"practiceLocations": [
{
"address_1": "1700 Lake St",
"address_purpose": "LOCATION",
"city": "Lake Providence",
"state": "LA",
"postal_code": "712545208",
"country_code": "US",
"telephone_number": "318-341-8147",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "TRAVION",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-01",
"last_updated": "2026-04-20",
"certification_date": "2026-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": "5423",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "012121095",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.