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General NPI Number Information
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NPI Number | 1720512825
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Entity Type | Organization
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Legal Business Name | KAREN G SELENBERG LCSW LLC
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 2420 ATHANIA PKWY STE 102
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City | METAIRIE
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State | LA
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Zip | 70001-1975
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Country | US
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Telephone | 504-833-6303
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Fax | 504-837-9857
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Provider Business Mailing Address
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Address Line | 146 AVANT GARDE CIR
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City | KENNER
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State | LA
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Zip | 70065-6273
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Country | US
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Telephone | 504-388-5110
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Fax | 504-837-9857
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Authorized Official
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Title or Position | OWNER
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Name | MS. KAREN G SELENBERG
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Credential | LCSW
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Telephone | 504-388-5110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 910
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License Number State | LA
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