Provider Demographics
NPI:1063845501
Name:ANTIPPAS, ATHENA (LPC-S, NCC, MS)
Entity Type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:ANTIPPAS
Suffix:
Gender:F
Credentials:LPC-S, NCC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 CANAL ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6082
Mailing Address - Country:US
Mailing Address - Phone:504-482-2735
Mailing Address - Fax:
Practice Address - Street 1:2601 TULANE AVE STE 610
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7454
Practice Address - Country:US
Practice Address - Phone:504-454-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4452101YP2500X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional