Organization
CARISSA BOKELBERG LLC PSYD
Active
Other names
Carissa L Bokelberg, Psy.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARISSA L BOKELBERG PSY.D. (CLINICAL PSYCHOLOGIST)
(504) 377-7779
Entity
Organization
Contact information
Practice address
3909 BIENVILLE ST, SUITE 102, NEW ORLEANS, LA 70119-5151
(504) 535-4372
(504) 273-1479
Mailing address
3114 PALMYRA ST, NEW ORLEANS, LA 70119-6220
(504) 377-7779
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1048
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307424
—
LA
Enumeration date
08/25/2011
Last updated
03/21/2012
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