MEDICARE: ASHLEY PARTRIDGE

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	1563	LA
2	1041C0700X	Clinical Social Worker	13621	LA

General Provider Information

NPI Number	:	1821489402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY PARTRIDGE

Provider Business Mailing Address
First Line	:	1615 CANAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2819
Country	:	US
Telephone Number	:	504-308-3295
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 CANAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2819
Country	:	US
Telephone Number	:	504-308-3295
Fax Number	:

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

Provider Enumeration Date	:	02/18/2015
Last Update Date	:	09/28/2016

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Directions to “ ASHLEY PARTRIDGE ” Practice Location

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