Provider Demographics
NPI:1467540484
Name:REED, ELISE HESTER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:HESTER
Last Name:REED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 E REYNOLDS DR STE H
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-2873
Mailing Address - Country:US
Mailing Address - Phone:318-251-4125
Mailing Address - Fax:318-251-5000
Practice Address - Street 1:206 E REYNOLDS DR STE H
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2873
Practice Address - Country:US
Practice Address - Phone:318-251-4125
Practice Address - Fax:318-251-5000
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4518101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3A068CV94Medicare PIN