Healthcare Provider Details

I. General information

NPI: 1912362500
Provider Name (Legal Business Name): KEISHA HENRY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5214 DAUPHINE ST
NEW ORLEANS LA
70117-3730
US

IV. Provider business mailing address

5214 DAUPHINE ST
NEW ORLEANS LA
70117-3730
US

V. Phone/Fax

Practice location:
  • Phone: 504-430-8158
  • Fax:
Mailing address:
  • Phone: 504-430-8158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number8536
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: