Healthcare Provider Details

I. General information

NPI: 1528322013
Provider Name (Legal Business Name): JULIE A ELLSWORTH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 ROBINHOOD DR
HAMMOND LA
70403-5754
US

IV. Provider business mailing address

130 ROBINHOOD DR
HAMMOND LA
70403-5754
US

V. Phone/Fax

Practice location:
  • Phone: 985-543-4800
  • Fax:
Mailing address:
  • Phone: 985-543-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8518
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number8518
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: