Healthcare Provider Details

I. General information

NPI: 1336506054
Provider Name (Legal Business Name): GWANGI'S COUNSELING RESEARCH TRAINING AND SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2314 BARTHOLOMEW ST
NEW ORLEANS LA
70117-5018
US

IV. Provider business mailing address

2314 BARTHOLOMEW ST
NEW ORLEANS LA
70117-5018
US

V. Phone/Fax

Practice location:
  • Phone: 504-655-5869
  • Fax:
Mailing address:
  • Phone: 504-655-5869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY S. JOHNSON
Title or Position: MHS
Credential: BSW
Phone: 504-655-5869