Healthcare Provider Details

I. General information

NPI: 1851232888
Provider Name (Legal Business Name): ASHLEY ESTALOTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 CM FAGAN DRIVE SUITE 1
HAMMOND LA
70403
US

IV. Provider business mailing address

206 E REYNOLDS DR STE E3
RUSTON LA
71270-2873
US

V. Phone/Fax

Practice location:
  • Phone: 775-420-8420
  • Fax:
Mailing address:
  • Phone: 318-232-2232
  • Fax: 318-301-3734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15648
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: