LISA JACK (NPI# 1942739404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942739404 |
| Entity Type | Individual |
| Full Name | LISA JACK |
| Practice Address |
613 East St Mamou LA 70554 |
| Mailing Address |
613 East St Mamou LA 70554-3911 |
| Practice Telephone | 3376551132 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2018-06-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922645035 | Lisa Jack | Behavior Technician | 2880 Pottsville Minersville Hwy # 135, Minersville, PA 17954-2027 | 2019-12-09 |
| 1891827457 | Lisa E. Jack | Psychologist | 2233 Hamline Ave N Ste 611, Saint Paul, MN 55113-5007 | 2007-03-09 |
| 1740210152 | Lisa M Jack | Nurse Practitioner | 2076 Lascassas Pike Ste B, Murfreesboro, TN 37130-2085 | 2006-07-03 |
| Street Address |
613 EAST ST |
| City | MAMOU |
| State | LA |
| Zip Code | 70554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891328498 | Sarah Marie Thibodeaux | Behavioral Analyst | 601 Poinciana Avenue, Mamou, LA 70554 | 2020-02-21 |
| 1225359136 | Juanita Golemon Moorman | Social Worker | 1610 6th St, Mamou, LA 70554 | 2010-06-15 |
| 1164485173 | Hossam Abdelmonem Abdel-rahman | Internal Medicine | 803 Poinciana Ave, Mamou, LA 70554 | 2006-04-10 |
| 1265730485 | Savoy Medical Management Group, Inc | Rehabilitation Unit | 801 Poinciana Ave, Mamou, LA 70554 | 2011-03-11 |
| 1760714497 | Savoy Medical Management Group, Inc. | General Acute Care Hospital | 801 Poinciana Ave, Mamou, LA 70554 | 2010-02-05 |
| 1477882033 | Savoy Medical Management Group, Inc. | General Acute Care Hospital | 801 Poinciana Ave, Mamou, LA 70554 | 2009-12-10 |
| 1144557927 | Savoy Medical Management Group, Inc. | Rehabilitation Unit | 801 Poinciana Ave, Mamou, LA 70554 | 2009-11-16 |
| 1801122585 | Savoy Medical Management Group, Inc. | Psychiatric Unit | 1610 7th St, Mamou, LA 70554 | 2009-10-30 |
| 1255667002 | Savoy Medical Management Group, Inc. | General Acute Care Hospital | 801 Poinciana Ave, Mamou, LA 70554 | 2009-10-29 |
| 1215087887 | Michael J Prejean | Psychiatry & Neurology | 1610 7th St, Mamou, LA 70554 | 2007-01-12 |
| Find all providers in zip 70554 | ||||
| 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 |
|---|---|---|---|---|
| 1174124762 | Mary Flemon | Case Manager/Care Coordinator | 733 Keyser Ave Ste 120, Natchitoches, LA 71457-0039 | 2020-11-02 |
| 1992305023 | Deonna Hawkins Jackson | Case Manager/Care Coordinator | 17616 Heritage Estates Dr, Baton Rouge, LA 70810-6579 | 2020-10-28 |
| 1306445713 | Beverly Jean Holmes | Case Manager/Care Coordinator | 9331 Foster Rd Apt C, Baton Rouge, LA 70811-2736 | 2020-10-19 |
| 1922606326 | Christie Hitchens | Case Manager/Care Coordinator | 1041 Chariot Dr, Baton Rouge, LA 70816-1842 | 2020-10-16 |
| 1134727514 | Shatiya Reshun Williams | Case Manager/Care Coordinator | 6121 Dauphine St, New Orleans, LA 70117-2109 | 2020-10-16 |
| 1750989190 | Bridgette Lynette Azoanee | Case Manager/Care Coordinator | 4119 Lake Sherwood Ave E, Baton Rouge, LA 70816-7322 | 2020-10-16 |
| 1447858923 | Ajona Lavallais | Case Manager/Care Coordinator | 521 Redbird Dr, Alexandria, LA 71303-3934 | 2020-10-15 |
| 1629676465 | Jessica Dennis | Case Manager/Care Coordinator | 2950 Chippewa St, Baton Rouge, LA 70805-8126 | 2020-10-14 |
| 1720686769 | Wyona Jordan | Case Manager/Care Coordinator | 6980 Saint Francis Ave, Baton Rouge, LA 70811-1419 | 2020-10-13 |
| 1043817331 | Wanda Frazier | Case Manager/Care Coordinator | 203 Robert Lee Cir, Lafayette, LA 70506-3130 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
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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.