Healthcare Provider Details

I. General information

NPI: 1306183108
Provider Name (Legal Business Name): TELITA OVIDE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 CANAL ST
NEW ORLEANS LA
70119-6082
US

IV. Provider business mailing address

3801 CANAL ST
NEW ORLEANS LA
70119-6082
US

V. Phone/Fax

Practice location:
  • Phone: 504-482-2735
  • Fax: 504-482-2737
Mailing address:
  • Phone: 504-482-2735
  • Fax: 504-482-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number11842
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11842
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number11842
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number11842
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number11842
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11842
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: