Provider Demographics
NPI:1093231367
Name:JAKES, WILNEISHA CHARRON (LMSW)
Entity type:Individual
Prefix:
First Name:WILNEISHA
Middle Name:CHARRON
Last Name:JAKES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:WILNEISHA
Other - Middle Name:CHARRON
Other - Last Name:JAKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:3033 BARDIN RD APT 105
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3859
Mailing Address - Country:US
Mailing Address - Phone:504-330-7340
Mailing Address - Fax:
Practice Address - Street 1:500 MADISON AVE STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1230
Practice Address - Country:US
Practice Address - Phone:567-312-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-18
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12377171M00000X, 104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator