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NPI Code Detail

MEDICARE: SANDRA M STAUB LPC

MEDICARE: SANDRA M STAUB LPC
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 Counselor4153LA

General Provider Information

NPI Number : 1811097603
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA M STAUB LPC
Provider Business Mailing Address
First Line : 1901 AIRLINE DR STE B
Second Line : CELEBRATION HOPE CENTER
City : METAIRIE
State : LA
Zip : 70001-5936
Country : US
Telephone Number : 504-833-4673
Fax Number : 504-885-0400
Provider Business Practice Location Address
First Line : 1901 AIRLINE DR STE B
Second Line : CELEBRATION HOPE CENTER
City : METAIRIE
State : LA
Zip : 70001-5936
Country : US
Telephone Number : 504-833-4673
Fax Number : 504-885-0400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 04/08/2013

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