Provider Demographics
NPI:1629625827
Name:INTEGRATED CARE AND CONSULTING LLC
Entity Type:Organization
Organization Name:INTEGRATED CARE AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN-LOMBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-781-0548
Mailing Address - Street 1:3674 PIN OAK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131
Mailing Address - Country:US
Mailing Address - Phone:504-475-3777
Mailing Address - Fax:985-781-4319
Practice Address - Street 1:3201 WALL BLVD
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7875
Practice Address - Country:US
Practice Address - Phone:504-475-3777
Practice Address - Fax:985-781-4319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA202115OtherMENTAL HEALTH GROUP