Provider Demographics
NPI:1528361979
Name:RODNEY, KEISA MAKEEBA (RSW)
Entity Type:Individual
Prefix:MRS
First Name:KEISA
Middle Name:MAKEEBA
Last Name:RODNEY
Suffix:
Gender:F
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 ANGELIQUE DR
Mailing Address - Street 2:
Mailing Address - City:VIOLET
Mailing Address - State:LA
Mailing Address - Zip Code:70092-2851
Mailing Address - Country:US
Mailing Address - Phone:504-682-9301
Mailing Address - Fax:504-682-9301
Practice Address - Street 1:2400 EDENBORN AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1817
Practice Address - Country:US
Practice Address - Phone:504-838-5275
Practice Address - Fax:504-838-5591
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9571104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker