Provider Demographics
NPI:1134584154
Name:DELAUNE, RONALD (LAC)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:DELAUNE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 KIM ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-3955
Mailing Address - Country:US
Mailing Address - Phone:504-495-1552
Mailing Address - Fax:504-827-2926
Practice Address - Street 1:411 S BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7410
Practice Address - Country:US
Practice Address - Phone:504-827-2928
Practice Address - Fax:504-827-2926
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1542171M00000X
LA1524101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator