Provider Demographics
NPI:1518323674
Name:STAGES OF CHANGE
Entity Type:Organization
Organization Name:STAGES OF CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TEKANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CSW
Authorized Official - Phone:504-338-3068
Mailing Address - Street 1:10001 LAKE FOREST BLVD # 906
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-6200
Mailing Address - Country:US
Mailing Address - Phone:504-338-3068
Mailing Address - Fax:504-827-1083
Practice Address - Street 1:2714 CANAL ST
Practice Address - Street 2:307
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5548
Practice Address - Country:US
Practice Address - Phone:504-641-0649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health