Healthcare Provider Details

I. General information

NPI: 1982667978
Provider Name (Legal Business Name): M. KATHIE WEBER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 GENERAL DEGAULLE DR SUITE 4098
NEW ORLEANS LA
70114-6757
US

IV. Provider business mailing address

3520 GENERAL DEGAULLE DR SUITE 4098
NEW ORLEANS LA
70114-6757
US

V. Phone/Fax

Practice location:
  • Phone: 504-362-8046
  • Fax: 504-362-2215
Mailing address:
  • Phone: 504-362-8046
  • Fax: 504-362-2215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2510
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: