Que'Ana Lache Morris Jackson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

931 Monroe Dr NE Ste A102-450
Atlanta, GA 30308-1793

Phone

(404) 789-4079

Fax

(877) 833-3855

NPI assigned

Oct 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• One Wellness Boutique, Inc.

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1669934030
  NPD Authorized official

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1972856805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303210294",
            "telephone_number": "404-789-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 MONROE DR NE STE A102-450",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081793",
            "telephone_number": "404-789-4079",
            "fax_number": "877-833-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS JACKSON",
        "first_name": "QUE'ANA",
        "middle_name": "LACHE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102X00000X",
            "taxonomy_group": "",
            "desc": "Poetry Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972856805",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Moros, MD
• Magaly Morquecho
• Cresse Merchant Morrell, BCBA
• Erika Morrell
• Jennifer Morrell
• Kaydeen Vandana Morris-Whyte, MD
• Amy Rostand Morris, LCSW
• Anna Burcham Morris
• Candace Morris, PT
• Carolyn Renee Morris

• Community Health Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Community Health Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.