MEDICARE: JESSICA CHRISTINE BOURNES-JASON LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	15626	LA

General Provider Information

NPI Number	:	1568929693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CHRISTINE BOURNES-JASON LMSW

Provider Business Mailing Address
First Line	:	6041 MOUNES ST APT Q253
Second Line	:
City	:	RIVER RIDGE
State	:	LA
Zip	:	70123-6000
Country	:	US
Telephone Number	:	702-234-4818
Fax Number	:

Provider Business Practice Location Address
First Line	:	10040 I 10 SERVICE RD STE B
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2701
Country	:	US
Telephone Number	:	504-821-8220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2019
Last Update Date	:	01/01/2023

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