Provider Demographics
NPI:1205031044
Name:LOUISIANA YOUTH ENHANCED SERVICES
Entity Type:Organization
Organization Name:LOUISIANA YOUTH ENHANCED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPOLL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:504-896-2636
Mailing Address - Street 1:210 STATE ST
Mailing Address - Street 2:COTTAGE #4
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5735
Mailing Address - Country:US
Mailing Address - Phone:504-896-2636
Mailing Address - Fax:504-896-2668
Practice Address - Street 1:8 VERSAILLES BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4114
Practice Address - Country:US
Practice Address - Phone:504-866-7576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.09289R2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty