Provider Demographics
NPI:1609371996
Name:WARD, TONCHELLE NICOLE (MHP)
Entity Type:Individual
Prefix:
First Name:TONCHELLE
Middle Name:NICOLE
Last Name:WARD
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7410
Mailing Address - Country:US
Mailing Address - Phone:504-827-2928
Mailing Address - Fax:
Practice Address - Street 1:411 S BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7410
Practice Address - Country:US
Practice Address - Phone:504-827-2928
Practice Address - Fax:504-827-2926
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator