Provider Demographics
NPI:1083888317
Name:MCGRAW, KATHLEEN OQUELI (PHD, MPH, LCSW, LAC)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:OQUELI
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:PHD, MPH, LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5860 CITRUS BOULEVARD, SUITE D#133
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123
Mailing Address - Country:US
Mailing Address - Phone:504-459-9839
Mailing Address - Fax:
Practice Address - Street 1:3350 RIDGELAKE DR STE 200
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3831
Practice Address - Country:US
Practice Address - Phone:504-459-9839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1399101YA0400X
MN286631041C0700X
LA1078405300000X
LA46441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No405300000XOther Service ProvidersPrevention Professional