MEDICARE: TEKANA GAINER RSW

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	13392	LA

General Provider Information

NPI Number	:	1720352255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEKANA GAINER RSW

Provider Business Mailing Address
First Line	:	2616 S JOHNSON ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-3812
Country	:	US
Telephone Number	:	504-338-3068
Fax Number	:	504-827-1083

Provider Business Practice Location Address
First Line	:	10001 LAKE FOREST BLVD STE 906
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-6200
Country	:	US
Telephone Number	:	504-338-3068
Fax Number	:	504-827-1086

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

Provider Enumeration Date	:	03/01/2012
Last Update Date	:	09/06/2023

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Directions to “ TEKANA GAINER RSW” Practice Location

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