Provider Demographics
NPI:1013403948
Name:BARABINO, LANESA MOET
Entity Type:Individual
Prefix:
First Name:LANESA
Middle Name:MOET
Last Name:BARABINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4437 KENNON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-1814
Mailing Address - Country:US
Mailing Address - Phone:504-481-7590
Mailing Address - Fax:
Practice Address - Street 1:1995 GENTILLY BLVD STE C-400
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-1700
Practice Address - Country:US
Practice Address - Phone:504-944-0453
Practice Address - Fax:504-944-0095
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA15955104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator