Healthcare Provider Details

I. General information

NPI: 1396924403
Provider Name (Legal Business Name): FAMILY SERVICE OF GREATER NEW ORLEANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 CANAL ST STE 201
NEW ORLEANS LA
70119-6435
US

IV. Provider business mailing address

2515 CANAL ST STE 201
NEW ORLEANS LA
70119-6435
US

V. Phone/Fax

Practice location:
  • Phone: 504-822-0800
  • Fax: 504-822-0831
Mailing address:
  • Phone: 504-822-0800
  • Fax: 504-822-0831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. RON MCCLAIN
Title or Position: PRESIDENT AND CEO
Credential: JD, LCSW
Phone: 504-827-4001