1821576117 NPI number — ERICA MONIQUE RIDGLEY RSW

Table of content: ERICA MONIQUE RIDGLEY RSW (NPI 1821576117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821576117 NPI number — ERICA MONIQUE RIDGLEY RSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIDGLEY
Provider First Name:
ERICA
Provider Middle Name:
MONIQUE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RSW
Provider Gender Code:
F

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:
1821576117
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2588 SCHWEGMANN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARRERO
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70072-5352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-758-2646
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VOLUNTEERS OF AMERICA SOUTHEAST LOUISIANA
Provider Second Line Business Practice Location Address:
3801 CANAL ST.
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-656-9437
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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