Provider Demographics
NPI:1881838365
Name:CHAUDHRY, SERENA (LMSW)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 BARONNE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-5314
Mailing Address - Country:US
Mailing Address - Phone:917-969-3418
Mailing Address - Fax:
Practice Address - Street 1:4011 BARONNE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-5314
Practice Address - Country:US
Practice Address - Phone:917-969-3418
Practice Address - Fax:917-969-3418
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC116391041C0700X, 101YM0800X, 101YP2500X
LA110971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432998199Medicaid