=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104536903
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATALIA SKEF-PROMOSLOVSKY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2022
-----------------------------------------------------
Last Update Date | 04/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2521 JENA ST STE 202
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70115-6322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-982-1701
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2404 JENA ST
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70115-5908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-982-1701
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER MANAGER
-----------------------------------------------------
Name | NATALIA DEBORAH SKEF-PROMOSLOVSKY
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 504-982-1701
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------