Healthcare Provider Details

I. General information

NPI: 1912225897
Provider Name (Legal Business Name): SELF-ENHANCEMENT CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 SAINT BERNARD AVE
NEW ORLEANS LA
70116-1329
US

IV. Provider business mailing address

2825 A P TUREAUD AVE
NEW ORLEANS LA
70119-1009
US

V. Phone/Fax

Practice location:
  • Phone: 504-944-0774
  • Fax: 504-944-0775
Mailing address:
  • Phone: 504-289-6854
  • Fax: 504-304-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLPC 2119
License Number StateLA

VIII. Authorized Official

Name: DR. ALFRED DOUGLAS WHITE JR.
Title or Position: OWNER / DIRECTOR
Credential: LPC; LMFT
Phone: 504-289-6854