Healthcare Provider Details

I. General information

NPI: 1881055598
Provider Name (Legal Business Name): ASHAUNTI EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3222 CANAL ST
NEW ORLEANS LA
70119-6252
US

IV. Provider business mailing address

7928 READ BLVD
NEW ORLEANS LA
70127-1324
US

V. Phone/Fax

Practice location:
  • Phone: 504-821-1788
  • Fax: 504-310-8781
Mailing address:
  • Phone: 504-284-8799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1366
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7704
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: