| Healthy Avenues Medical Group Llc | |
|
3303 Tulane Ave Bldg 1 New Orleans LA 70119-7186 | |
| (504) 377-6628 | |
| (833) 907-2256 |
| Full Name | Healthy Avenues Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3303 Tulane Ave Bldg 1, New Orleans, Louisiana |
| Authorized Official Name and Position | Danielle Gaudin (OWNER) |
| Authorized Official Contact | 5048837199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Avenues Medical Group Llc 3303 Tulane Ave Bldg 1 New Orleans LA 70119-7186 Ph: (504) 377-6628 | Healthy Avenues Medical Group Llc 3303 Tulane Ave Bldg 1 New Orleans LA 70119-7186 Ph: (504) 377-6628 |
| NPI Number | 1659093847 |
|---|---|
| Provider Enumeration Date | 09/14/2022 |
| Last Update Date | 07/12/2023 |
| Certification Date | 07/12/2023 |
| Medicare PECOS PAC ID | 7416313630 |
|---|---|
| Medicare Enrollment ID | O20230515000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659093847 | NPI | - | NPPES |
| 20130196 | Other | LA | LOUISIANA NURSING LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lee Michals |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154687754 PECOS PAC ID: 6709182025 Enrollment ID: I20170510000997 |
| Provider Name | Tyshica Lofton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942656921 PECOS PAC ID: 0244587376 Enrollment ID: I20180720001520 |
| Provider Name | Maria J Salmeron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851868764 PECOS PAC ID: 7911240155 Enrollment ID: I20190510000267 |
| Provider Name | Sandra H Truett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295337921 PECOS PAC ID: 7012361652 Enrollment ID: I20230929002493 |
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