LATISHA JACKSON (NPI# 1134408636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134408636 |
| Entity Type | Individual |
| Full Name | LATISHA JACKSON |
| Credential | LPC |
| Practice Address |
2500 Rike Dr Pine Bluff AR 71603-3937 |
| Practice Telephone | 8705341834 |
| Practice Fax Number | 8705345798 |
| Mailing Telephone | 8705341834 |
| Mailing Fax Number | 8705345798 |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2015-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
P1412110 | AR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 116378726 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225595200 | Latisha Lashon Jackson | Social Worker | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2019-02-26 |
| 1922577196 | Latisha Ranae Jackson | Behavior Technician | 260 Peachtree St Nw Ste 2200, Atlanta, GA 30303-1292 | 2018-11-17 |
| 1861977639 | Latisha Jackson | Counselor | 3073 Salt Lake Rd, Indianapolis, IN 46214-1432 | 2018-09-27 |
| 1487912580 | Latisha Evette Jackson | Counselor | 4417 Oasis Plains Ave, North Las Vegas, NV 89085-2334 | 2012-04-25 |
| 1548446537 | Latisha Nicole Jackson | Counselor | 820 23rd St, Richmond, CA 94804-1338 | 2008-01-21 |
| 1831313170 | Latisha Jackson | Counselor | 125 E Cheves St, Florence, SC 29506-2526 | 2007-04-11 |
| Street Address |
2500 RIKE DR |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-3937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235170382 | Joyce Walker | Social Worker | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2006-06-09 |
| 1174122451 | Barbara Ellison | Registered Nurse | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2020-10-19 |
| 1619509916 | Reginald Pace | Counselor | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2020-02-05 |
| 1336786946 | Robyne Watley | Counselor | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2019-12-02 |
| 1891332508 | Brionna Davis | Counselor | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2019-12-02 |
| 1083256820 | Marious Tolbert | Counselor | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2019-10-14 |
| 1629552278 | Lanivia Morris | Counselor | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2018-09-19 |
| 1184131880 | Cassandra K Edwards | Registered Nurse | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2018-01-03 |
| 1417461989 | Holly E Dial | Registered Nurse | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2017-11-20 |
| 1104356328 | Aerielle Lawrence | Counselor | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2017-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649480260 | Terry Anderson | Counselor | 2500 Rike Dr, Pine Bluff, AR 71603-3937 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899986 | Cynthia Hrdlichka | Counselor | 2224 E Elaine Ave, Fayetteville, AR 72703-4507 | 2020-10-20 |
| 1568069169 | Blaire Bradbury | Counselor | 1466 N Desoto Pl, Fayetteville, AR 72703-1953 | 2020-10-06 |
| 1063029460 | Onward and Upward Counseling, Pllc | Counselor | 100 North Rockingchair Road, Ste 3, Paragould, AR 72450 | 2020-09-29 |
| 1932712064 | Lavana J. Kindle | Counselor | Victory Church 1283 Us-278 W, Camden, AR 71701-4551 | 2020-08-28 |
| 1275141202 | Leslie Meeker | Counselor | 10068 Buckskin Cir, Rogers, AR 72758-7575 | 2020-07-15 |
| 1710509997 | Dickerson Family Resource Center, LLC | Counselor | 5401 John F. Kennedy Blvd, Suite I Rm 1, North Little Rock, AR 72116 | 2020-05-11 |
| 1114557824 | Elysian Counseling Services Pllc | Counselor | 1024 W Court St Ste C, Paragould, AR 72450-4130 | 2020-01-22 |
| 1588294631 | Puzzle Collaborative | Counselor | 34 W Colt Square Dr Ste 1, Fayetteville, AR 72703-2888 | 2020-01-16 |
| 1487290888 | John Hunter Bramlitt | Counselor | 12320 I-30, Little Rock, AR 72210 | 2019-11-20 |
| 1114562071 | Ariel Brown | Counselor | 10 Remington Dr, Little Rock, AR 72204-8202 | 2019-11-14 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on LATISHA JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.