Troy A Jackson
Case Manager/Care Coordinator in Shreveport, LA. Individual provider (NPI-1).
NPI number1982146668
StatusActive
Last updated in NPPESJan 17, 2019
Details
- NPI
- 1982146668
- Entity type
- Individual (NPI-1)
- Name
- Mr. Troy A Jackson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 10, 2016
- Last updated
- Jan 17, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
1513 Line Ave Suite 222Shreveport, LA 71107-6503
Phone 318-208-8908 · Fax 318-208-8935
Mailing address
1513 Line Ave Suite 222Shreveport, LA 71101-6503
Phone 318-208-8908 · Fax 318-208-8935
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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