JOSEPH GRANVILLE JACKSON (NPI# 1891152773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891152773 |
| Entity Type | Individual |
| Full Name | JOSEPH GRANVILLE JACKSON |
| Credential | CCS, RAC |
| Practice Address |
411 Sparrow St Lake Providence LA 71254-3035 |
| Mailing Address |
706 Sparrow St Lake Providence LA 71254-3520 |
| Practice Telephone | 3185593356 |
| Practice Fax Number | 3185592044 |
| Mailing Telephone | 3185593356 |
| Mailing Fax Number | 3185592044 |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1300 | LA | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
186 | LA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538560123 | Joseph Ryan Jackson | Chiropractor | 1043 Brownsville Rd, Morgantown, KY 42261-7011 | 2014-09-15 |
| 1922392927 | Joseph Alling Jackson | Social Worker | 66 Old Stockbridge Rd, Lenox, MA 01240-2810 | 2011-06-07 |
| 1760708127 | Joseph L Jackson | Dentist | 1241 Riverside Ave, Fort Collins, CO 80524-3204 | 2010-04-10 |
| 1962731315 | Joseph S Jackson | Counselor | 502 Downing Ct, Exton, PA 19341-2090 | 2009-12-14 |
| 1851547749 | Joseph Loy Jackson | Dentist | 2719 Limestone Pkwy, Gainesville, GA 30501-1472 | 2008-08-12 |
| 1235306143 | Joseph Jackson | Physical Therapist | 15640 S Normandie Ave, Gardena, CA 90247-4016 | 2008-05-09 |
| 1518175520 | Joseph William Jackson | Dentist | 322 N Elm St, Oxford, OH 45056-1123 | 2007-05-21 |
| 1801918602 | Joseph C Jackson Jr. | Dentist | 147 2nd Ave S Ste 308, Saint Petersburg, FL 33701-4393 | 2007-04-04 |
| 1073633624 | Joseph A Jackson | Psychiatry & Neurology | 30941 Mill Ln Ste G-132, Spanish Fort, AL 36527-5456 | 2007-03-29 |
| 1649352691 | Joseph Barry Jackson | Optometrist | 3323 Frontage Rd, Peru, IL 61354-1101 | 2006-10-19 |
| Street Address |
411 SPARROW ST |
| City | LAKE PROVIDENCE |
| State | LA |
| Zip Code | 71254-3035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306317953 | Alisa Bell | Counselor | 411 Sparrow St, Lake Providence, LA 71254-3035 | 2018-12-07 |
| 1639612476 | Delta Community Enhancement Program | Community/Behavioral Health | 411 Sparrow St, Lake Providence, LA 71254-3035 | 2016-11-28 |
| 1578005906 | Elisha Lucas | Counselor | 411 Sparrow St, Lake Providence, LA 71254-3035 | 2016-11-16 |
| 1700233079 | Delta Community Action Association, Inc. | Community/Behavioral Health | 411 Sparrow St, Lake Providence, LA 71254-3035 | 2016-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225571821 | Sade' Finley | Counselor | 1700 Lake Street, Lake Providence, LA 71254 | 2016-11-30 |
| 1194176792 | Changing Lives Counseling and Mentoring, LLC | Community/Behavioral Health | 202 Lake St, Lake Providence, LA 71254 | 2016-06-24 |
| 1326494972 | Ingrid Dandrea Lockhart | Counselor | 1700 Lake Road, Lake Providence, LA 71254 | 2016-05-12 |
| 1013183003 | Personal Careall | Hospice Care, Community Based | 3959 Schrock Drive, Lake Providence, LA 71254 | 2008-04-30 |
| 1750310272 | George Fakhre | Internal Medicine | 221 N Hood, Lake Providence, LA 71254 | 2006-06-30 |
| 1194239806 | Shirley Anne Lyons | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2017-11-17 |
| 1225588700 | Courtney Michelle Wingate | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-10-10 |
| 1649622721 | Keanda Walker | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-07-12 |
| 1346698792 | Tonya Denise Gordon | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-05-26 |
| 1356797971 | Sheila Bell | Counselor | 1700 Lake St, Lake Providence, LA 71254 | 2016-05-12 |
| Find all providers in zip 71254 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114138 | Thomas Rowan | Counselor | 63069 Hummingbird Ln, Mandeville, LA 70448-7306 | 2020-11-05 |
| 1760089106 | Patricia Riley Mceacharn | Counselor | 161 Coumeaux Rd, Rayville, LA 71269 | 2020-10-08 |
| 1982211140 | Adonis Williams | Counselor | 410 E Askew Street, Tallulah, LA 71282 | 2020-09-30 |
| 1942814389 | Courtney Rayburn | Counselor | 9413 Prestonwood Dr, Shreveport, LA 71115-3733 | 2020-09-02 |
| 1780202127 | Allison Skapik | Counselor | 2700 South Broad St, New Orleans, LA 70125 | 2020-07-13 |
| 1386266922 | Kayla Richards | Counselor | 6201 Venecia Dr, Bossier City, LA 71111-7448 | 2020-05-16 |
| 1659993392 | Eugenia Colthia Washington | Counselor | 336 Lakewood Ave, Breaux Bridge, LA 70517-3235 | 2020-05-15 |
| 1801416060 | Renovo Wellness, LLC | Counselor | 10771 Perkins Rd Ste C, Baton Rouge, LA 70810-1693 | 2020-04-17 |
| 1558999656 | Kindred Counseling | Counselor | 1420 Avenue I, Bogalusa, LA 70427-4955 | 2020-04-01 |
| 1689200073 | Denise Lynn Guillot | Counselor | 10627 Hwy 71, Cheneyville, LA 71325-1325 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
| City | LAKE PROVIDENCE |
| Zip Code | 71254 |
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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.