Healthcare Provider Details

I. General information

NPI: 1649026576
Provider Name (Legal Business Name): RE'CHANDA TEEKEMA WOODS PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 DRIFTWOOD CIR
SLIDELL LA
70458-1467
US

IV. Provider business mailing address

9 CHESAPEAKE PLZ
CHESAPEAKE OH
45619-1003
US

V. Phone/Fax

Practice location:
  • Phone: 985-788-8208
  • Fax:
Mailing address:
  • Phone: 985-788-8208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10449
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number65501
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: