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General NPI Number Information
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NPI Number | 1790550580
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Entity Type | Individual
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Provider Name | CHARRLYSE SANDIFER LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 11/24/2023
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Provider Practice Location Address
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Address Line | 4480 GENERAL DEGAULLE DR STE 206
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City | NEW ORLEANS
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State | LA
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Zip | 70131-6309
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Country | US
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Telephone | 504-905-6945
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Fax |
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Provider Business Mailing Address
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Address Line | 5419 TULLIS DR
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City | NEW ORLEANS
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State | LA
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Zip | 70131-8592
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Country | US
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Telephone | 504-391-7323
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11489
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License Number State | LA
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