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NPI Code Detail

MEDICARE: DAVAUGHN PHILLIPS

MEDICARE: DAVAUGHN PHILLIPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator
3104100000XSocial Worker13528LA

General Provider Information

NPI Number : 1194181628
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVAUGHN PHILLIPS
Provider Business Mailing Address
First Line : 3431 REPUBLIC ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70122-2348
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4300 S I 10 SERVICE RD W STE 215
Second Line :
City : METAIRIE
State : LA
Zip : 70001-7436
Country : US
Telephone Number : 504-301-9990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2016
Last Update Date : 05/16/2025

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Directions to “ DAVAUGHN PHILLIPS ” Practice Location

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