MEDICARE: ELLIOTT LOVE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	251S00000X	Community/Behavioral Health Agency
3	261QM0850X	Adult Mental Health Clinic/Center
4	261QM0855X	Adolescent and Children Mental Health Clinic/Center
5	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1962874719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLIOTT LOVE

Provider Business Mailing Address
First Line	:	2968 GENERAL COLLINS AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6859
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2968 GENERAL COLLINS AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-6859
Country	:	US
Telephone Number	:	504-232-5345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2015
Last Update Date	:	12/22/2022

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Directions to “ ELLIOTT LOVE ” Practice Location

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