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General NPI Number Information
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NPI Number | 1114138856
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Entity Type | Organization
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Legal Business Name | JEFFERSON PSYCHIATRIC ASSOCIATES
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 3901 HOUMA BLVD STE 401
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City | METAIRIE
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State | LA
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Zip | 70006-2930
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Country | US
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Telephone | 504-889-1448
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Fax | 504-889-1452
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Provider Business Mailing Address
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Address Line | 3901 HOUMA BLVD STE 401
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City | METAIRIE
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State | LA
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Zip | 70006-2930
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Country | US
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Telephone | 504-889-1448
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Fax | 504-889-1452
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Authorized Official
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Title or Position | OWNER
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Name | SIDNEY K SMITH III
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Credential | MD
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Telephone | 504-889-1448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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