Healthcare Provider Details

I. General information

NPI: 1790333805
Provider Name (Legal Business Name): CDS HEALTHCARE CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 STUMPF BLVD BLDG 4 STE 3
GRETNA LA
70056-8636
US

IV. Provider business mailing address

PO BOX 1831
GRETNA LA
70054-1831
US

V. Phone/Fax

Practice location:
  • Phone: 504-814-0380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CASSANDRA SMITH
Title or Position: FOUNDER/LEAD CONSULTANT
Credential: LCSW-BACS
Phone: 504-814-0830