Healthcare Provider Details

I. General information

NPI: 1952808040
Provider Name (Legal Business Name): CHLOE ANTOINETTE PICKETT LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 11/02/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 N HULLEN ST STE 203
METAIRIE LA
70001-6913
US

IV. Provider business mailing address

1821 OPELOUSAS AVE UNIT C
NEW ORLEANS LA
70114
US

V. Phone/Fax

Practice location:
  • Phone: 228-627-3435
  • Fax:
Mailing address:
  • Phone: 228-627-3435
  • Fax: 228-627-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1668
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number654232
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: