Healthcare Provider Details

I. General information

NPI: 1033664412
Provider Name (Legal Business Name): COUNSELING SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 PRYTANIA ST SUITE 18
NEW ORLEANS LA
70115-3628
US

IV. Provider business mailing address

1800 WILLIAMS BLVD
KENNER LA
70062-8211
US

V. Phone/Fax

Practice location:
  • Phone: 504-575-4662
  • Fax:
Mailing address:
  • Phone: 504-575-4662
  • Fax: 504-305-0983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4144
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8520
License Number StateLA

VIII. Authorized Official

Name: ELISSA S MILLMAN
Title or Position: CEO
Credential: LCSW-BACS
Phone: 504-575-4662