Provider Demographics
NPI:1891593737
Name:WOODS, MICAH
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:
Last Name:WOODS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4523 NEW ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-3022
Mailing Address - Country:US
Mailing Address - Phone:504-235-8915
Mailing Address - Fax:
Practice Address - Street 1:9641 OLD GENTILLY RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-4324
Practice Address - Country:US
Practice Address - Phone:504-235-8915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator