Carissa Lyn Bokelberg, PSY.D.
Individual provider Active NPI Clinical Psychologist · New Orleans, LA
NPI 1255529798 · NPPES record last updated Feb 24, 2011
Key facts
- NPI
- 1255529798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1048 (LA)
- Practice address
- 4640 S Carrollton Ave
Suite 235
New Orleans, LA 70119-6051 - Phone
- (504) 780-1702
- Fax
- (504) 780-1705
- NPI assigned
- Oct 10, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1048 | LA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carissa Bokelberg LLC PSYD | Clinical | Past |
Accepting new patients |
| Bianchini-Niemeier, LLC | Clinical | Past | Accepting new patients |
| Nursing Home Psychological Services of Louisiana LLC | Clinical | Past | Accepting new patients |
| Bianchini-Bokelberg, LLC | Past |
Accepting new patients | |
| Nursing Home Psychological Services LLC | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1048 | LA | Yes |
Addresses
Primary practice location
4640 S Carrollton Ave
Suite 235
New Orleans, LA 70119-6051
Mailing address
4640 S Carrollton Ave
Suite 235
New Orleans, LA 70119-6051
Phone (504) 780-1702
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1307424 | Medicaid | LA |
Other providers in New Orleans, LA
- Jenna Bogaczyk
- Koren M Boggs
- Erin Elizabeth Boh
- Humberto Elias Bohorquez
- Leonard Robert Bok
- George Arthur Bokelberg
- Bol Medical L.L.C.
- Corey Patrick Boland
- Jamie Lee Bolden
- Lindsey Rose Bolden
All providers in New Orleans, LA · Clinical Psychologist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.