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General NPI Number Information
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NPI Number | 1184916231
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Entity Type | Individual
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Provider Name | DR. MARIO ALBERTO SACASA
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Gender | Male
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 4833 CONTI ST STE 206
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City | NEW ORLEANS
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State | LA
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Zip | 70119-4368
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Country | US
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Telephone | 504-264-3905
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Fax |
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Provider Business Mailing Address
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Address Line | 4833 CONTI ST STE 206
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City | NEW ORLEANS
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State | LA
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Zip | 70119-4368
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Country | US
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Telephone | 504-264-3905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT 2423
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT1109
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License Number State | LA
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