Healthcare Provider Details

I. General information

NPI: 1376645903
Provider Name (Legal Business Name): GARRY L ELDRIDGE LPC; LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 POYDRAS ST SUITE 1400
NEW ORLEANS LA
70130-6101
US

IV. Provider business mailing address

650 POYDRAS ST SUITE 1400
NEW ORLEANS LA
70130-6101
US

V. Phone/Fax

Practice location:
  • Phone: 504-259-6889
  • Fax: 504-525-1488
Mailing address:
  • Phone: 504-259-6889
  • Fax: 504-525-1488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1381
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number3584
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1381
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number625
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: