MS. CHANDRA ALISA JACKSON (NPI# 1164934998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164934998 |
| Entity Type | Individual |
| Full Name | MS. CHANDRA ALISA JACKSON |
| Credential | MHP |
| Practice Address |
1058 E Worthy St Ste B-2 Gonzales LA 70737-4302 |
| Practice Telephone | 2254503216 |
| Practice Fax Number | 2254503799 |
| Mailing Telephone | 2254503216 |
| Mailing Fax Number | 2254503799 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2019-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1366981557 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689151664 | Chandra Jackson | Counselor | 1224 Stokley Pl, Baton Rouge, LA 70815-7030 | 2018-07-23 |
| 1982243853 | Chandra Jackson | Social Worker | 367 Pine St, Springfield, MA 01105-1930 | 2019-12-24 |
| 1093080756 | Chandra Jackson | Licensed Practical Nurse | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2012-03-14 |
| Street Address |
1058 E WORTHY ST STE B-2 |
| City | GONZALES |
| State | LA |
| Zip Code | 70737-4302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952944787 | Juquilla Miller Batiste | Homemaker | 1058 E Worthy St Ste B-2, Gonzales, LA 70737-4359 | 2019-10-24 |
| 1770097610 | Lequatta C Vessel | Counselor | 1058 E Worthy St Ste B-2, Gonzales, LA 70737-4302 | 2017-11-30 |
| 1427560176 | Lisa C Jasper | Community Health Worker | 1058 E Worthy St Ste B-2, Gonzales, LA 70737-4302 | 2017-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
| 1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
| 1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
| 1407347586 | Functional Dme | Prosthetic/Orthotic Supplier | 219 W. Eastbank St., Ste B, Gonzales, LA 70737 | 2018-05-23 |
| 1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
| 1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
| 1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
| 1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
| 1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
| Find all providers in zip 70737 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396393104 | Rozina Marie Perkins | Case Manager/Care Coordinator | 2814 S Meadowood Ave, Gonzales, LA 70737-4737 | 2019-08-27 |
| 1609335546 | Josten Nishan Milan | Case Manager/Care Coordinator | 2228 S Burnside Ave Trlr 218, Gonzales, LA 70737-4629 | 2019-03-19 |
| 1922590850 | Vanessa Herrera | Case Manager/Care Coordinator | 28496 Corda Road, Gonzales, CA 93926 | 2018-06-06 |
| 1508307968 | Khadijah Kashay Simmons | Case Manager/Care Coordinator | 630 W Cornerview St, Gonzales, LA 70737-2742 | 2017-03-17 |
| 1992177448 | Karen Boseman | Case Manager/Care Coordinator | 14086 Airline Hwy Apt 1918, Gonzales, LA 70737-0618 | 2015-10-23 |
| 1730717315 | Rebecca Ovide | Case Manager/Care Coordinator | 630 W Cornerview St, Gonzales, LA 70737-2742 | 2020-03-30 |
| 1316409089 | Katelyn Roth | Case Manager/Care Coordinator | 108 E Sanders St, Gonzales, LA 70737-3144 | 2019-04-02 |
| 1477010171 | Darnisha Leblanc | Case Manager/Care Coordinator | 108 E Sanders St, Gonzales, LA 70737-3144 | 2019-02-28 |
| 1457817793 | Keri Ann Chilton | Case Manager/Care Coordinator | 108 E Sanders St, Gonzales, LA 70737-3144 | 2019-02-12 |
| 1205390317 | Sinee Bethany Solite | Case Manager/Care Coordinator | 108 E Sanders St, Gonzales, LA 70737-3144 | 2019-01-23 |
| Find all providers in GONZALES | ||||
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| 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.