MODEACON LATRELL JACKSON SR.
NPI 1891208823
Counselor - Mental Health in Monroe, LA

Q: What is Modeacon Jackson's NPI number?

The NPI number for Modeacon Jackson is 1891208823. It was assigned to this individual provider in the NPPES registry on November 13, 2017.

Q: What is Modeacon Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Modeacon Jackson was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 November 13, 2017

1702 BERNSTEIN PARK RD, MONROE, LA 71202(318) 331-3440 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 17, 2018, Nov 13, 2017 (2 updates tracked since 2017).

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About Modeacon Latrell Jackson Sr. NPPES

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

MODEACON LATRELL JACKSON SR. (NPI 1891208823) is an individual mental health provider in Monroe, Louisiana and active in the NPI registry since November 2017. He maintains a secondary practice location in Monroe.

NPPES Registry Identity

NPI1891208823

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMODEACON LATRELL JACKSON SR.

Location Address1702 BERNSTEIN PARK RDMonroe, LA 71202-5502

Mailing Address1702 Bernstein Park RdMonroe, LA 71202-5502 · (318) 331-3440

Phone(318) 331-3440

Sole ProprietorYes

Enumeration DateNovember 13, 2017

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1891208823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

1702 BERNSTEIN PARK RD, Monroe, LA 71202

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Secondary Practice Location 1

Location 11702 Bernstein Park RdMonroe, LA 71202-5502 · Phone (318) 331-3440

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 Modeacon Jackson's NPI number?

The NPI number for Modeacon Jackson is 1891208823. It was assigned to this individual provider in the NPPES registry on November 13, 2017.

Where is Modeacon Jackson located?

Modeacon Jackson practices at 1702 Bernstein Park Rd, Monroe, LA 71202. The listed phone number is (318) 331-3440.

What is Modeacon Jackson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Modeacon Jackson was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.