| Nola Professional Services | |
|
5302 Dauphine St New Orleans LA 70117-3732 | |
| (504) 383-3033 | |
| (833) 799-3463 |
| Full Name | Nola Professional Services |
|---|---|
| Speciality | Social Worker |
| Location | 5302 Dauphine St, New Orleans, Louisiana |
| Authorized Official Name and Position | Mark D. Drake (OWNER) |
| Authorized Official Contact | 5043833033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nola Professional Services 5302 Dauphine St New Orleans LA 70117-3732 Ph: (504) 383-3033 | Nola Professional Services 5302 Dauphine St New Orleans LA 70117-3732 Ph: (504) 383-3033 |
| NPI Number | 1609658327 |
|---|---|
| Provider Enumeration Date | 10/17/2023 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 3375992084 |
|---|---|
| Medicare Enrollment ID | O20231206003240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609658327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mark Drake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982881736 PECOS PAC ID: 9537236120 Enrollment ID: I20231206002033 |
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