REBIRTH MENTAL HEALTH SERVICES LLC (NPI# 1972113124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972113124 |
| Entity Type | Organization |
| Organization Name | REBIRTH MENTAL HEALTH SERVICES LLC |
| Practice Address |
2116 Gause Blvd W Ste E Slidell LA 70460-4120 |
| Practice Telephone | 2252230847 |
| Practice Fax Number | 9856057388 |
| Mailing Telephone | 2252230847 |
| Mailing Fax Number | 9856057388 |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-10-09 |
| Authorized Official Name | TIFFANY FARMER VICKERS (PMHNP/OWNER) |
| Authorized Official Telephone | 2252230847 |
| Authorized Official Credential | PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2116 GAUSE BLVD W STE E |
| City | SLIDELL |
| State | LA |
| Zip Code | 70460-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316575434 | Southern Healthcare of Louisiana | Family Medicine | 1340 Gause Blvd W, Slidell, LA 70460 | 2020-04-01 |
| 1336600758 | Alex Duc Pham | Student in an Organized Health Care Education/Training Program | 210 Tiara Dr., Slidell, LA 70460 | 2019-03-28 |
| 1992163851 | Teem Economic Research & Business Community Development, Inc. | Case Management | 36190 Hwy 433, Slidell, LA 70460 | 2016-02-08 |
| 1548607674 | Louisiana Dental Professionals, Donovan Dronet, Dds, A Professional De | Dentist | 2170 Gause Boulevard, Suite 133, Slidell, LA 70460 | 2013-05-30 |
| 1164764478 | Carrie Dale Howard | Speech-Language Pathologist | 305 Royal Drive, Slidell, LA 70460 | 2013-03-25 |
| 1427326446 | M L D Institute of Louisiana, LLC | Clinic/Center | 1274 Saint Tammany Ave, Slidell, LA 70460 | 2011-12-05 |
| 1497039069 | Royalty Home Care Service | Home Health | 328 Queen Anne Dr, Slidell, LA 70460 | 2011-09-30 |
| 1154616134 | James Sibley Holmes | Obstetrics & Gynecology | 107 Mary Ellen Dr, Slidell, LA 70460 | 2011-06-17 |
| 1700175734 | Timothy James Moten | Pharmacist | 114 Gause, Slidell, LA 70460 | 2011-03-30 |
| 1205064599 | Ochsner Clinic LLC | Durable Medical Equipment & Medical Supplies | 2104 Highway 190 W, Slidell, LA 70460 | 2009-06-25 |
| Find all providers in zip 70460 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263853 | Jeffery Vezain | Nurse Practitioner | 113 Christian Ln, Slidell, LA 70458-1377 | 2020-04-14 |
| 1881227106 | Megan Seals | Nurse Practitioner | 113 Christian Ln, Slidell, LA 70458-1377 | 2020-02-14 |
| 1578193603 | Dominique Ganier Dorsey | Nurse Practitioner | 2331 Carey St, Slidell, LA 70458-3627 | 2020-01-16 |
| 1912565698 | Dionna Crespo | Nurse Practitioner | 113 Christian Ln, Slidell, LA 70458-1377 | 2019-05-29 |
| 1114400439 | Gloria Roussell Stewart | Nurse Practitioner | 113 Christian Ln, Slidell, LA 70458-1377 | 2018-09-12 |
| 1891152906 | Cathy Davis | Nurse Practitioner | 2331 Carey St, Slidell, LA 70458-3627 | 2016-01-20 |
| 1003168071 | Jaime Rebecca Loebner | Nurse Practitioner | 113 Christian Ln, Slidell, LA 70458-1350 | 2012-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427668748 | Julie Susann Dyrek | Nurse Practitioner | 1 Lakeshore Dr Ste 1830, Lake Charles, LA 70629-0114 | 2020-08-01 |
| 1376169979 | Nancy Ariwodo | Nurse Practitioner | 225 Rue La France, Lafayette, LA 70508-1565 | 2020-06-19 |
| 1578183208 | Donald Glyn Gardner II | Nurse Practitioner | 324 Blue Fox Cir, Haughton, LA 71037-7707 | 2020-04-22 |
| 1629604129 | Raelyn Marie Plauche | Nurse Practitioner | 1951 Florida Ave Sw Ste D&e, Denham Springs, LA 70726-4947 | 2020-03-16 |
| 1962035964 | Tyler Trenton Wansley | Nurse Practitioner | 23515 Us-190, Mandeville, LA 70448 | 2020-02-18 |
| 1114558715 | Danielle J Threatts Aprn LLC | Nurse Practitioner | 208 W Gloria Switch Rd Ste 219, Lafayette, LA 70507-3409 | 2020-02-01 |
| 1992359848 | Harold G Frizzell Psychiatric Services LLC | Nurse Practitioner | 300 Thompson Loop, Lafayette, LA 70506-2820 | 2019-07-29 |
| 1598227779 | Candyce Brown | Nurse Practitioner | 333 Dr Michael Debakey Dr Ste 220, Lake Charles, LA 70601-5888 | 2019-04-04 |
| 1659835346 | Cassandra Thomas-jingles Psychiatric Nurse Practitioner, LLC. | Nurse Practitioner | 156 Mcgehee Dr, Baton Rouge, LA 70815-5012 | 2019-01-26 |
| 1508335910 | Oh Project- Southshore | Nurse Practitioner | 23515 U.S. 190, Northlake Academy Building, Mandeville, LA 70447 | 2018-11-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.