Provider Demographics
NPI:1114656873
Name:ELMORE, CEE A'LAINE (SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:CEE
Middle Name:A'LAINE
Last Name:ELMORE
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 SAINT ANTHONY AVE APT 221
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4160
Mailing Address - Country:US
Mailing Address - Phone:504-308-1220
Mailing Address - Fax:
Practice Address - Street 1:1799 STUMPF BLVD
Practice Address - Street 2:BLDG 3 STE 6A
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:504-266-2522
Practice Address - Fax:504-308-1400
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17053104100000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA000000Medicaid