LATRICE VERNICE JACKSON


Address: 1415 E 10th St, 2425 Lenore St., Shawnee, OK 74801-7801
Phone: 4053827623

LATRICE VERNICE JACKSON (NPI# 1275800997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275800997
Entity Type Individual
Full Name LATRICE VERNICE JACKSON
Practice Address 1415 E 10th St
2425 Lenore St.
Shawnee
OK 74801-7801
Practice Telephone 4053827623
Mailing Telephone 4053827623
Enumeration Date 2011-11-23
Last Update Date 2016-01-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers

Office Location

Street Address 1415 E 10TH ST
2425 LENORE ST.
City SHAWNEE
State OK
Zip Code 74801-7801

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538609037 Melissa Lanier Specialist 801 N. Louisa, Shawnee, OK 74801 2017-03-02
1518365287 Melanie A. Croy Counselor 1605 N. Harrison, Shawnee, OK 74801 2014-12-12
1134532229 Megan Malouf Registered Nurse 2307 Gordon Cooper Dr., Shawnee, OK 74801 2014-06-05
1063836609 Daniel Antwain Shaw Counselor 605 S. Pottenger Ave, Shawnee, OK 74801 2014-02-18
1639514862 Cheryl Jeannette Left Hand Counselor 101 N. Union, Shawnee, OK 74801 2013-05-01
1881948644 Lena I Samilton Counselor 319 S. Kennedy Ave., Apt.112, Shawnee, OK 74801 2012-11-01
1235433681 Jenifer Sloan Case Manager/Care Coordinator 2029 S. Gordon Cooper Dr., Shawnee, OK 74801 2010-12-28
1295854958 Jack C Luman Dentist 1410 N Harrison St, Shawnee, OK 74801 2007-03-27
1942375274 M Gerald Ball Psychologist 819 North Kickapoo, Shawnee, OK 74801 2006-11-21
1205912573 Regina Steciak Tanner Physical Therapist 909 N Kickapoo, Shawnee, OK 74801 2006-10-31
Find all providers in zip 74801

Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417431081 Cura Counseling and Professional Development LLC Counselor 611 N Bonita Ave, Shawnee, OK 74801-6038 2018-09-19
1134614589 Sayble Paige Turner Counselor 600 W Independence St Ste 1000, Shawnee, OK 74804-4320 2018-06-28
1548707169 Courtney J Vaughn Counselor 600 W Independence St Ste 9010, Shawnee, OK 74804-4320 2017-01-20
1538567284 Virgil Newport Jr. Counselor 2524 N Harrison St Trlr 8, Shawnee, OK 74804-3103 2014-12-11
1386064426 Cassandra Alexander Counselor 6305 Moon Lake Cir, Shawnee, OK 74804-2649 2014-04-16
1063836609 Daniel Antwain Shaw Counselor 605 S. Pottenger Ave, Shawnee, OK 74801 2014-02-18
1639514862 Cheryl Jeannette Left Hand Counselor 101 N. Union, Shawnee, OK 74801 2013-05-01
1386981017 Janet Wilson Counselor 6826 Lackman Rd, Shawnee, KS 66217-9595 2013-01-15
1891051330 Malita Elice Green Counselor 102 Ashley Dr, Shawnee, OK 74804-9710 2012-04-10
1689941510 Reginald Johnson Counselor 14203 Brangus Rd, Shawnee, OK 74804-3330 2011-11-21
Find all providers in SHAWNEE

Competitor

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City SHAWNEE
Zip Code 74801

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Dataset Information

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.

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