Healthcare Provider Details

I. General information

NPI: 1326412966
Provider Name (Legal Business Name): TANYA WELSH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 01/28/2020
Certification Date: 01/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 TULANE AVE STE 610
NEW ORLEANS LA
70119-7454
US

IV. Provider business mailing address

1233 FRANCIS ST
MARRERO LA
70072-2513
US

V. Phone/Fax

Practice location:
  • Phone: 504-453-3740
  • Fax:
Mailing address:
  • Phone: 504-338-4064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11712
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11712
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number11712
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: