Healthcare Provider Details

I. General information

NPI: 1285089169
Provider Name (Legal Business Name): KATINA WHORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 BIENVILLE ST STE 4
NEW ORLEANS LA
70112-3183
US

IV. Provider business mailing address

4480 GEN DEGAULLE DR STE. 117
NEW ORLEANS LA
70131-6941
US

V. Phone/Fax

Practice location:
  • Phone: 504-332-8962
  • Fax:
Mailing address:
  • Phone: 504-309-6798
  • Fax: 504-407-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number15973
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: