Healthcare Provider Details

I. General information

NPI: 1770954232
Provider Name (Legal Business Name): RANI JOSEPH MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RANI JOSEPH

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 ASBURY DR
MANDEVILLE LA
70471-1842
US

IV. Provider business mailing address

2150 GENERAL PERSHING STREET
MANDEVILLE LA
70448
US

V. Phone/Fax

Practice location:
  • Phone: 985-674-5155
  • Fax: 985-674-5156
Mailing address:
  • Phone: 985-674-5155
  • Fax: 985-674-5156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12291
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number12291
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: