Healthcare Provider Details

I. General information

NPI: 1679062178
Provider Name (Legal Business Name): BETH CHRISTENSEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 N CLARK ST
NEW ORLEANS LA
70119-5244
US

IV. Provider business mailing address

137 N CLARK ST
NEW ORLEANS LA
70119-5244
US

V. Phone/Fax

Practice location:
  • Phone: 504-210-9521
  • Fax: 504-309-1491
Mailing address:
  • Phone: 504-210-9521
  • Fax: 504-309-1491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number3951
License Number StateLA

VIII. Authorized Official

Name: DR. ELIZABETH CHRISTENSEN
Title or Position: OWNER
Credential: PHD, LPC
Phone: 504-210-9521