Healthcare Provider Details

I. General information

NPI: 1750048344
Provider Name (Legal Business Name): MALAINA DOMINIQUE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 CANAL ST STE 325
NEW ORLEANS LA
70119-6059
US

IV. Provider business mailing address

5919 PARIS AVE
NEW ORLEANS LA
70122-2723
US

V. Phone/Fax

Practice location:
  • Phone: 504-702-6729
  • Fax:
Mailing address:
  • Phone: 504-388-5706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
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: