Provider Demographics
NPI:1710307301
Name:BIANCHINI-OGDEN&EPKER/PENRY
Entity Type:Organization
Organization Name:BIANCHINI-OGDEN&EPKER/PENRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIANCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-780-1702
Mailing Address - Street 1:2901 N I 10 SERVICE RD E
Mailing Address - Street 2:STE 300
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6137
Mailing Address - Country:US
Mailing Address - Phone:504-780-1702
Mailing Address - Fax:504-780-1705
Practice Address - Street 1:7101 US HIGHWAY 90
Practice Address - Street 2:STE 102
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9512
Practice Address - Country:US
Practice Address - Phone:504-780-1702
Practice Address - Fax:504-780-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1871103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty