Healthcare Provider Details

I. General information

NPI: 1013403948
Provider Name (Legal Business Name): LANESA MOET BARABINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 GENTILLY BLVD STE C-400
NEW ORLEANS LA
70119-1700
US

IV. Provider business mailing address

4437 KENNON AVE
NEW ORLEANS LA
70122-1814
US

V. Phone/Fax

Practice location:
  • Phone: 504-944-0453
  • Fax: 504-944-0095
Mailing address:
  • Phone: 504-481-7590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number15955
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: