Provider Demographics
NPI:1770954232
Name:JOSEPH, RANI (MSW)
Entity type:Individual
Prefix:
First Name:RANI
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:RANI
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2150 GENERAL PERSHING STREET
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448
Mailing Address - Country:US
Mailing Address - Phone:985-674-5155
Mailing Address - Fax:985-674-5156
Practice Address - Street 1:820 ASBURY DR
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-1842
Practice Address - Country:US
Practice Address - Phone:985-674-5155
Practice Address - Fax:985-674-5156
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12291171M00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator