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General NPI Number Information
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NPI Number | 1447652359
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Entity Type | Individual
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Provider Name | JACINTA SHANAY JAMISON
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Gender | Female
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 1210 STUBBS AVE
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City | MONROE
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State | LA
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Zip | 71201-5622
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Country | US
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Telephone | 318-325-8748
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Fax | 318-325-8749
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Provider Business Mailing Address
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Address Line | 333 WOODALE DR UNIT 5
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City | MONROE
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State | LA
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Zip | 71203-2791
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Country | US
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Telephone | 318-362-3339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9218
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License Number State | LA
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