Individual
MS. KISHA ANN PENDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2432 LARK ST, NEW ORLEANS, LA 70122-4322
(504) 908-5859
Mailing address
2432 LARK ST, NEW ORLEANS, LA 70122-4322
(504) 908-5859
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3972
LA
101YM0800X
Mental Health Counselor
3972
LA
101YP2500X
Professional Counselor
Primary
3972
LA
103K00000X
Behavior Analyst
3972
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3972
LCSW
LA
Enumeration date
07/18/2013
Last updated
07/18/2013
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