NPIMap

Organization Active NPI

Carissa Bokelberg LLC PSYD

Doing business as Carissa L Bokelberg, Psy.D.

  • Clinical Psychologist
  • New Orleans, LA
National Provider Identifier
1639459399
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1048 Issued in LA
Legal business name
CARISSA BOKELBERG LLC PSYD
Doing business as
Carissa L Bokelberg, Psy.D.
Practice address
3909 Bienville St
Suite 102
New Orleans, LA 70119-5151
Phone
(504) 535-4372
Fax
(504) 273-1479
NPI assigned
Aug 25, 2011
Last updated
Mar 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Carissa L Bokelberg, PSY.D.NPI 1255529798
Title
Clinical Psychologist
Phone
(504) 377-7779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1048 LA Primary

Addresses

Primary practice location

3909 Bienville St
Suite 102
New Orleans, LA 70119-5151

Mailing address

3114 Palmyra St
New Orleans, LA 70119-6220
Phone (504) 377-7779

Other identifiers 1

IdentifierTypeStateIssuer
1307424MedicaidLA

Other names 1

  • Carissa L Bokelberg, Psy.D. Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1639459399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 PALMYRA ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701196220",
            "telephone_number": "504-377-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 BIENVILLE ST",
            "address_2": "SUITE 102",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701195151",
            "telephone_number": "504-535-4372",
            "fax_number": "504-273-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARISSA BOKELBERG LLC PSYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "BOKELBERG",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "504-377-7779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1307424",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carissa L Bokelberg, Psy.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.