JOSEPH GRANVILLE JACKSON CCS, RAC
NPI 1891152773
Counselor - Addiction (Substance Use Disorder) in Lake Providence, LA

Q: What is Joseph Jackson's NPI number?

The NPI number for Joseph Jackson is 1891152773. It was assigned to this individual provider in the NPPES registry on January 22, 2016.

Q: What is Joseph Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Joseph Jackson was last updated on January 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 22, 2016

411 SPARROW ST, LAKE PROVIDENCE, LA 71254(318) 559-3356(318) 559-2044 Get Directions Write a Review

NPPES record last updated: January 22, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Joseph Granville Jackson Ccs, Rac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSEPH GRANVILLE JACKSON CCS, RAC (NPI 1891152773) is an individual addiction (substance use disorder) provider in Lake Providence, Louisiana, licensed in Louisiana (186) and active in the NPI registry since January 2016.

NPPES Registry Identity

NPI1891152773

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameJOSEPH GRANVILLE JACKSONCredential: CCS, RAC

Location Address411 SPARROW STLake Providence, LA 71254-3035

Mailing Address706 Sparrow StLake Providence, LA 71254-3520 · (318) 559-3356 · Fax (318) 559-2044

Phone(318) 559-3356

Fax(318) 559-2044

Sole ProprietorNo

Enumeration DateJanuary 22, 2016

✔ NPI 1891152773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

Licenses✔ Licensed in LA · 186✔ Licensed in LA · 1300

411 SPARROW ST, Lake Providence, LA 71254

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Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALISA BELL

Counselor (Mental Health)

411 SPARROW ST
LAKE PROVIDENCE, LA 71254

East Carroll Parish (318) 559-3356

ELISHA LUCAS

Counselor (Mental Health)

411 SPARROW ST
LAKE PROVIDENCE, LA 71254

East Carroll Parish (318) 559-3356

DELTA COMMUNITY ENHANCEMENT PROGRAM

Community/Behavioral Health

411 SPARROW ST
LAKE PROVIDENCE, LA 71254

East Carroll Parish (318) 559-3356

DELTA COMMUNITY ACTION ASSOCIATION, INC.

Community/Behavioral Health

411 SPARROW ST
LAKE PROVIDENCE, LA 71254

East Carroll Parish (318) 559-3356

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Joseph Jackson's NPI number?

The NPI number for Joseph Jackson is 1891152773. It was assigned to this individual provider in the NPPES registry on January 22, 2016.

Where is Joseph Jackson located?

Joseph Jackson practices at 411 Sparrow St, Lake Providence, LA 71254. The listed phone number is (318) 559-3356.

What is Joseph Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Joseph Jackson was last updated on January 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.