Provider Demographics
NPI:1154700821
Name:JIMISON, DAYNA L (MSW, LMSW, QSSW)
Entity type:Individual
Prefix:
First Name:DAYNA
Middle Name:L
Last Name:JIMISON
Suffix:
Gender:F
Credentials:MSW, LMSW, QSSW
Other - Prefix:
Other - First Name:DAYNA
Other - Middle Name:J
Other - Last Name:BONDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, CSW, LMSW
Mailing Address - Street 1:8 REDBUD LN
Mailing Address - Street 2:
Mailing Address - City:SAINT ROSE
Mailing Address - State:LA
Mailing Address - Zip Code:70087-3453
Mailing Address - Country:US
Mailing Address - Phone:504-402-1750
Mailing Address - Fax:
Practice Address - Street 1:822 S CLEARVIEW PKWY
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-3401
Practice Address - Country:US
Practice Address - Phone:504-656-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA159511041C0700X, 171M00000X, 1041S0200X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1701033Medicaid