Healthcare Provider Details

I. General information

NPI: 1023460896
Provider Name (Legal Business Name): DONNA MICHELLE JACKSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DONNA LEWIS

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7343 READ BLVD
NEW ORLEANS LA
70127
US

IV. Provider business mailing address

7343 READ BLVD
NEW ORLEANS LA
70127-2227
US

V. Phone/Fax

Practice location:
  • Phone: 504-812-3451
  • Fax:
Mailing address:
  • Phone: 504-952-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7502
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: