Provider Demographics
NPI:1174034078
Name:CLAY, JAKIA (MSW, CSW)
Entity Type:Individual
Prefix:
First Name:JAKIA
Middle Name:
Last Name:CLAY
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 PRYTANIA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3600
Mailing Address - Country:US
Mailing Address - Phone:504-899-5437
Mailing Address - Fax:504-896-2240
Practice Address - Street 1:3600 PRYTANIA ST STE 100
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3600
Practice Address - Country:US
Practice Address - Phone:504-899-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12643104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker