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NPI Code Detail

MEDICARE: LONGBRANCH OUTPATIENT RECOVERY, LLC

MEDICARE: LONGBRANCH OUTPATIENT RECOVERY, LLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional Counselor
3103TC0700XClinical Psychologist
4103TC1900XCounseling Psychologist
5103TP0016XPrescribing (Medical) Psychologist
61041C0700XClinical Social Worker
7106H00000XMarriage & Family Therapist
82084P0800XPsychiatry Physician
92084P0802XAddiction Psychiatry Physician
10261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
11261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
12323P00000XPsychiatric Residential Treatment Facility
13324500000XSubstance Abuse Rehabilitation Facility
14261QR0800XRecovery Care Clinic/Center

General Provider Information

NPI Number : 1578091104
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONGBRANCH OUTPATIENT RECOVERY, LLC
Provider Business Mailing Address
First Line : 2329 EDENBORN AVE
Second Line :
City : METAIRIE
State : LA
Zip : 70001-1815
Country : US
Telephone Number : 504-635-3535
Fax Number : 985-273-3869
Provider Business Practice Location Address
First Line : 2329 EDENBORN AVE
Second Line :
City : METAIRIE
State : LA
Zip : 70001-1815
Country : US
Telephone Number : 504-635-3535
Fax Number : 985-273-3869
Authorized Official
Title or Position : CEO
Name : EMILY ELIZABETH MEYERS
Credential : LPC
Telephone Number : 920-309-0541
Provider Enumeration Date : 05/26/2017
Last Update Date : 12/23/2024

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