Provider Demographics
NPI:1801540927
Name:CELIUS, DAMANITRA
Entity type:Individual
Prefix:MS
First Name:DAMANITRA
Middle Name:
Last Name:CELIUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7709 DEVINE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-1117
Mailing Address - Country:US
Mailing Address - Phone:504-314-8064
Mailing Address - Fax:504-525-4483
Practice Address - Street 1:3801 CANAL ST STE 325
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6059
Practice Address - Country:US
Practice Address - Phone:504-483-3558
Practice Address - Fax:504-525-4483
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker