MEDICARE: KRISTEN OBBO BA

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
1	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator		LA

General Provider Information

NPI Number	:	1881109817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN OBBO BA

Provider Business Mailing Address
First Line	:	2540 SEVERN AVE STE 100
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-5941
Country	:	US
Telephone Number	:	504-454-3740
Fax Number	:	540-454-3738

Provider Business Practice Location Address
First Line	:	2540 SEVERN AVE STE 100
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-5941
Country	:	US
Telephone Number	:	504-454-3740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2017
Last Update Date	:	06/21/2026

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Directions to “ KRISTEN OBBO BA” Practice Location

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