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NPI Code Detail

MEDICARE: THERATIQUE

MEDICARE: THERATIQUE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor2811LA

General Provider Information

NPI Number : 1093184384
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERATIQUE
Provider Business Mailing Address
First Line : 4008 CANAL ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-6021
Country : US
Telephone Number : 504-681-7030
Fax Number : 888-959-6762
Provider Business Practice Location Address
First Line : 4008 CANAL ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-6021
Country : US
Telephone Number : 504-681-7030
Fax Number : 888-959-6762
Authorized Official
Title or Position : OWNER
Name : HOPE M GERSOVITZ
Credential :
Telephone Number : 504-669-1980
Provider Enumeration Date : 09/17/2015
Last Update Date : 06/08/2026

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Directions to “THERATIQUE ” Practice Location

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