Provider Demographics
NPI:1821808866
Name:PLATER, JADA ALISSE
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:ALISSE
Last Name:PLATER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 3RD ST SE APT 204
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3213
Mailing Address - Country:US
Mailing Address - Phone:202-421-0899
Mailing Address - Fax:
Practice Address - Street 1:4319 3RD ST SE APT 204
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3213
Practice Address - Country:US
Practice Address - Phone:202-421-0899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
MD10272070832101Y00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No101Y00000XBehavioral Health & Social Service ProvidersCounselor