Healthcare Provider Details

I. General information

NPI: 1699169029
Provider Name (Legal Business Name): REBECCA GARSIDE COUNSELING & CONSULTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8237 OAK ST STUDIO A
NEW ORLEANS LA
70118-2041
US

IV. Provider business mailing address

8717 OAK ST
NEW ORLEANS LA
70118-1223
US

V. Phone/Fax

Practice location:
  • Phone: 504-388-5791
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number4317
License Number StateLA

VIII. Authorized Official

Name: REBECCA GARSIDE
Title or Position: OWNER
Credential:
Phone: 504-388-5791