Provider Demographics
NPI:1144682998
Name:JACKSON, CRASHADA
Entity type:Individual
Prefix:
First Name:CRASHADA
Middle Name:
Last Name:JACKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CRASHADA
Other - Middle Name:
Other - Last Name:ARMANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:422 CORTEZ ST
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2961
Mailing Address - Country:US
Mailing Address - Phone:504-810-4322
Mailing Address - Fax:
Practice Address - Street 1:2439 MANHATTAN BLVD STE 308
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5396
Practice Address - Country:US
Practice Address - Phone:504-366-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional