Healthcare Provider Details

I. General information

NPI: 1841826963
Provider Name (Legal Business Name): ELIZABETH VITTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2606 S CARROLLTON AVE
NEW ORLEANS LA
70118-3067
US

IV. Provider business mailing address

2606 S CARROLLTON AVE
NEW ORLEANS LA
70118-3067
US

V. Phone/Fax

Practice location:
  • Phone: 504-441-6276
  • Fax:
Mailing address:
  • Phone: 504-441-6276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number11799
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: