Healthcare Provider Details

I. General information

NPI: 1326428269
Provider Name (Legal Business Name): PODESTA PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4322 CANAL ST
NEW ORLEANS LA
70119-5945
US

IV. Provider business mailing address

1511 METAIRIE RD SUITE 22
METAIRIE LA
70005-3938
US

V. Phone/Fax

Practice location:
  • Phone: 504-252-0026
  • Fax: 504-322-3854
Mailing address:
  • Phone: 504-252-0026
  • Fax: 504-322-3854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ARWEN PODESTA
Title or Position: OWNER/MD
Credential: MD
Phone: 504-252-0026