Healthcare Provider Details

I. General information

NPI: 1346573565
Provider Name (Legal Business Name): SEAN MICHAEL RANSOM PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 MAGAZINE ST
NEW ORLEANS LA
70115-1735
US

IV. Provider business mailing address

4904 MAGAZINE ST
NEW ORLEANS LA
70115-1735
US

V. Phone/Fax

Practice location:
  • Phone: 504-383-3815
  • Fax: 855-502-8887
Mailing address:
  • Phone: 504-383-3815
  • Fax: 855-502-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1096
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSYC.PY.61406683
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberMP.0024
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1109
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: