Provider Demographics
NPI:1588771877
Name:FAMILY THERAPY INSTITUTE OF GREATER NEW ORLEANS, LLC
Entity type:Organization
Organization Name:FAMILY THERAPY INSTITUTE OF GREATER NEW ORLEANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-905-4120
Mailing Address - Street 1:1529 RIVER OAKS RD W
Mailing Address - Street 2:SUITE #106
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2162
Mailing Address - Country:US
Mailing Address - Phone:504-891-2464
Mailing Address - Fax:504-891-7882
Practice Address - Street 1:1529 RIVER OAKS RD W
Practice Address - Street 2:SUITE #106
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-2162
Practice Address - Country:US
Practice Address - Phone:504-891-2464
Practice Address - Fax:504-891-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CP94Medicare ID - Type UnspecifiedLLC