Healthcare Provider Details

I. General information

NPI: 1215592852
Provider Name (Legal Business Name): SARA CORDELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

824 ELMWOOD PARK BLVD NATIONAL CHILD AND FAMILY SERVICES
NEW ORLEANS LA
70123
US

IV. Provider business mailing address

4708 BELLE DR APT D
METAIRIE LA
70006-2265
US

V. Phone/Fax

Practice location:
  • Phone: 504-266-2576
  • Fax:
Mailing address:
  • Phone: 260-466-6906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6187
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: