Provider Demographics
NPI:1427484104
Name:CRAIGE-ROBERSON, ADA MONIQUE (EDD, LCSW-BACS)
Entity type:Individual
Prefix:DR
First Name:ADA
Middle Name:MONIQUE
Last Name:CRAIGE-ROBERSON
Suffix:
Gender:F
Credentials:EDD, LCSW-BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6207
Mailing Address - Country:US
Mailing Address - Phone:504-899-4461
Mailing Address - Fax:504-899-4464
Practice Address - Street 1:4219 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6207
Practice Address - Country:US
Practice Address - Phone:504-899-4461
Practice Address - Fax:504-899-4464
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA46051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical