Healthcare Provider Details

I. General information

NPI: 1831627314
Provider Name (Legal Business Name): KELLY TRENIKA HORTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 38TH ST
KENNER LA
70065-2806
US

IV. Provider business mailing address

501 MANHATTAN BLVD
HARVEY LA
70058-4443
US

V. Phone/Fax

Practice location:
  • Phone: 504-468-1016
  • Fax:
Mailing address:
  • Phone: 504-645-9667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14343
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: