MEDICARE: CELINE GENDRON

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
1	104100000X	Social Worker	18689	LA
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1477100790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINE GENDRON

Provider Business Mailing Address
First Line	:	3525 N CAUSEWAY BLVD STE 501
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-3697
Country	:	US
Telephone Number	:	504-309-0259
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 RIDGELAKE DR STE 309
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-4938
Country	:	US
Telephone Number	:	504-309-0259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2019
Last Update Date	:	11/24/2025

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Directions to “ CELINE GENDRON ” Practice Location

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