Provider Demographics
NPI:1467092841
Name:GEAUX TALK COUSELING SERVICES
Entity Type:Organization
Organization Name:GEAUX TALK COUSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/CRED
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEMETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-756-6860
Mailing Address - Street 1:3425 EDENBORN AVE APT 147
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3378
Mailing Address - Country:US
Mailing Address - Phone:504-559-5701
Mailing Address - Fax:504-345-2796
Practice Address - Street 1:2235 POYDRAS ST STE A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7561
Practice Address - Country:US
Practice Address - Phone:504-358-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty