Healthcare Provider Details

I. General information

NPI: 1699222380
Provider Name (Legal Business Name): KEISHA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 ALABO ST
NEW ORLEANS LA
70117-2005
US

IV. Provider business mailing address

5500 N RAMPART ST
NEW ORLEANS LA
70117-2502
US

V. Phone/Fax

Practice location:
  • Phone: 504-777-0917
  • Fax:
Mailing address:
  • Phone: 504-777-0917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: