Healthcare Provider Details

I. General information

NPI: 1770115305
Provider Name (Legal Business Name): HEALTHY CHANGES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 CANAL ST STE 305
NEW ORLEANS LA
70119-5570
US

IV. Provider business mailing address

3157 GENTILLY BLVD # 2412
NEW ORLEANS LA
70122-3872
US

V. Phone/Fax

Practice location:
  • Phone: 504-373-4467
  • Fax: 888-340-8273
Mailing address:
  • Phone: 504-373-4467
  • Fax: 888-340-8273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHAKAKHAN JARREAU-GRIFFIN
Title or Position: CEO
Credential: LCSW
Phone: 504-373-4467