Healthcare Provider Details

I. General information

NPI: 1992669741
Provider Name (Legal Business Name): ALEXIS NICOLE MCDONALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SAINT CHARLES AVE STE 2500
NEW ORLEANS LA
70170-2500
US

IV. Provider business mailing address

40315 PUMPKIN CENTER RD
HAMMOND LA
70403-1831
US

V. Phone/Fax

Practice location:
  • Phone: 985-402-0522
  • Fax:
Mailing address:
  • Phone: 985-402-0522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: