1114656873 NPI number — MS. CEE A'LAINE ELMORE SOCIAL WORKER

Table of content: MS. CEE A'LAINE ELMORE SOCIAL WORKER (NPI 1114656873)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114656873 NPI number — MS. CEE A'LAINE ELMORE SOCIAL WORKER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELMORE
Provider First Name:
CEE
Provider Middle Name:
A'LAINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
SOCIAL WORKER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114656873
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 SAINT ANTHONY AVE APT 221
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70122-4160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-308-1220
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1799 STUMPF BLVD
Provider Second Line Business Practice Location Address:
BLDG 3 STE 6A
Provider Business Practice Location Address City Name:
TERRYTOWN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70056-3950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-266-2522
Provider Business Practice Location Address Fax Number:
504-308-1400
Provider Enumeration Date:
06/08/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  17053 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X , with the licence number: 17053 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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