| Modern Day Therapy Llc | |
|
3501 Severn Ave Ste 20k Metairie LA 70002-3458 | |
| (504) 276-4862 | |
| Not Available |
| Full Name | Modern Day Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3501 Severn Ave Ste 20k, Metairie, Louisiana |
| Authorized Official Name and Position | Angelique T Williams (OWNER / MANAGER) |
| Authorized Official Contact | 5042764862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Day Therapy Llc 3501 Severn Ave Ste 20k Metairie LA 70002-3458 Ph: (504) 276-4862 | Modern Day Therapy Llc 3501 Severn Ave Ste 20k Metairie LA 70002-3458 Ph: (504) 276-4862 |
| NPI Number | 1730546383 |
|---|---|
| Provider Enumeration Date | 01/26/2016 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Medicare PECOS PAC ID | 3577868223 |
|---|---|
| Medicare Enrollment ID | O20160218000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730546383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angelique Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134594666 PECOS PAC ID: 0749583029 Enrollment ID: I20160218001314 |
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