Healthcare Provider Details

I. General information

NPI: 1649116278
Provider Name (Legal Business Name): ERIC M. DISHONGH PHD LPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

13101 RIVER RD
LULING LA
70070-4165
US

IV. Provider business mailing address

13101 RIVER RD
LULING LA
70070-4165
US

V. Phone/Fax

Practice location:
  • Phone: 504-606-1267
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ERIC M DISHONGH
Title or Position: OWNER
Credential:
Phone: 504-606-1267