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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
Street Address |
1415 E 10TH ST 2425 LENORE ST. |
City | SHAWNEE |
State | OK |
Zip Code | 74801-7801 |
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 Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
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 |
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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.