Provider Demographics
NPI:1164897708
Name:FAMILY SERVICE OF GREATER NEW ORLEANS
Entity Type:Organization
Organization Name:FAMILY SERVICE OF GREATER NEW ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINCIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAZANDA
Authorized Official - Middle Name:PRISCILLA
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-827-4005
Mailing Address - Street 1:2515 CANAL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119
Mailing Address - Country:US
Mailing Address - Phone:504-827-4005
Mailing Address - Fax:504-822-0831
Practice Address - Street 1:2515 CANAL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6435
Practice Address - Country:US
Practice Address - Phone:504-827-4005
Practice Address - Fax:504-822-0831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5054251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health