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NPI Code Detail

MEDICARE: MS. ELLEN LYNN SANTOLUCITO L.P.C.

MEDICARE: MS. ELLEN LYNN SANTOLUCITO L.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor20069TX

General Provider Information

NPI Number : 1003092404
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELLEN LYNN SANTOLUCITO L.P.C.
Provider Business Mailing Address
First Line : 6217 LESLIE ST
Second Line :
City : METAIRIE
State : LA
Zip : 70003-3230
Country : US
Telephone Number : 504-251-6277
Fax Number :
Provider Business Practice Location Address
First Line : 2901 RIDGELAKE DR STE 108
Second Line :
City : METAIRIE
State : LA
Zip : 70002-4946
Country : US
Telephone Number : 504-251-6277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2008
Last Update Date : 05/23/2022

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