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NPI Code Detail

MEDICARE: YVETTE THIERRY

MEDICARE: YVETTE THIERRY
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 CounselorLA
2171M00000XCase Manager/Care Coordinator4017LA
3101YA0400XAddiction (Substance Use Disorder) Counselor4017LA

General Provider Information

NPI Number : 1861863276
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVETTE THIERRY
Provider Business Mailing Address
First Line : 4329 VIXEN ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70131-6651
Country : US
Telephone Number : 504-239-0121
Fax Number : 504-367-6601
Provider Business Practice Location Address
First Line : 2968 GEN COLLINS AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70114-6859
Country : US
Telephone Number : 504-394-5937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2015
Last Update Date : 11/27/2018

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