Healthcare Provider Details

I. General information

NPI: 1114474491
Provider Name (Legal Business Name): MS. PERNEITA T PRICE-SYLVE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 PHILIP ST STE 209
NEW ORLEANS LA
70113-2525
US

IV. Provider business mailing address

4620 DREUX AVE
NEW ORLEANS LA
70126
US

V. Phone/Fax

Practice location:
  • Phone: 504-620-2315
  • Fax: 504-826-2672
Mailing address:
  • Phone: 504-813-9098
  • Fax: 504-826-2672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
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: