Healthcare Provider Details

I. General information

NPI: 1104492834
Provider Name (Legal Business Name): STEPHANIE GELVIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2317 ETIENNE DR
MERAUX LA
70075-2586
US

IV. Provider business mailing address

2317 ETIENNE DR
MERAUX LA
70075-2586
US

V. Phone/Fax

Practice location:
  • Phone: 504-912-2718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number8332
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: