Provider Demographics
NPI:1043660988
Name:SALAAM, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SALAAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 MUMPHREY RD
Mailing Address - Street 2:APT 1
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-5602
Mailing Address - Country:US
Mailing Address - Phone:504-553-7498
Mailing Address - Fax:
Practice Address - Street 1:10001 LAKE FOREST BLVED
Practice Address - Street 2:STE 404
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127
Practice Address - Country:US
Practice Address - Phone:504-821-5220
Practice Address - Fax:504-821-6330
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health