Healthcare Provider Details

I. General information

NPI: 1114536901
Provider Name (Legal Business Name): TONI FERDIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2053 GAUSE BLVD E STE 150
SLIDELL LA
70461-5451
US

IV. Provider business mailing address

2053 GAUSE BLVD E STE 150
SLIDELL LA
70461-5451
US

V. Phone/Fax

Practice location:
  • Phone: 985-649-1001
  • Fax:
Mailing address:
  • Phone: 985-649-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16212
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: