Basic Information
| Provider Information | |||||||||
| NPI: | 1265873061 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRIGHTMAN | ||||||||
| FirstName: | FELICE | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | SR. | ||||||||
| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6141 S HERMES ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701262636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043179053 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7809 AIRLINE DR STE 305A | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700036448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042671234 | ||||||||
| FaxNumber: | 5043242094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2013 | ||||||||
| LastUpdateDate: | 08/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.