1134464464 NPI number — ORI COUNSELING SERVICE OF NEW ORLEANS, LLC

Table of content: (NPI 1134464464)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134464464 NPI number — ORI COUNSELING SERVICE OF NEW ORLEANS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORI COUNSELING SERVICE OF NEW ORLEANS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134464464
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 750608
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70175-0608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-460-4193
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2601 N HULLEN ST
Provider Second Line Business Practice Location Address:
STE. 237
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70002-5900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-460-4193
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2012

Additional Information

Authorized Official

Authorized Official Last Name:
GIPSON
Authorized Official First Name:
LASHONDA
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
504-460-4193

Provider Taxonomy Codes

  • Taxonomy code: 302F00000X , with the licence number:  3937 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3937 . This is a "LPC" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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