Provider Demographics
NPI:1689914301
Name:BOURGEOIS, ELIZABETH BEU (MS, LPC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BEU
Last Name:BOURGEOIS
Suffix:
Gender:F
Credentials:MS, LPC, ATR-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:BEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4221
Mailing Address - Country:US
Mailing Address - Phone:504-220-1483
Mailing Address - Fax:888-248-7189
Practice Address - Street 1:1000 VETERANS BLVD STE 310
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2862
Practice Address - Country:US
Practice Address - Phone:504-220-1483
Practice Address - Fax:888-248-7189
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-16
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4891101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3562570Medicaid