Healthcare Provider Details

I. General information

NPI: 1629625827
Provider Name (Legal Business Name): INTEGRATED CARE AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 WALL BLVD
GRETNA LA
70056-7875
US

IV. Provider business mailing address

3674 PIN OAK AVE
NEW ORLEANS LA
70131
US

V. Phone/Fax

Practice location:
  • Phone: 504-475-3777
  • Fax: 985-781-4319
Mailing address:
  • Phone: 504-475-3777
  • Fax: 985-781-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DONISHA DUNN-LOMBARD
Title or Position: OWNER
Credential: MD
Phone: 985-781-0548