Healthcare Provider Details

I. General information

NPI: 1497599815
Provider Name (Legal Business Name): ZHANIYA LIDDELL MSW,CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7240 CROWDER BLVD STE 400
NEW ORLEANS LA
70127-1923
US

IV. Provider business mailing address

6640 COVENTRY ST
NEW ORLEANS LA
70126-1706
US

V. Phone/Fax

Practice location:
  • Phone: 504-323-3440
  • Fax:
Mailing address:
  • Phone: 504-358-1698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number19436
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: