Provider Demographics
NPI:1730309519
Name:LINDSEY, ELLIS EDWIN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ELLIS
Middle Name:EDWIN
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 RIVER OAKS RD W STE 110
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2162
Mailing Address - Country:US
Mailing Address - Phone:504-734-1740
Mailing Address - Fax:
Practice Address - Street 1:1529 RIVER OAKS RD W STE 110
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-2162
Practice Address - Country:US
Practice Address - Phone:504-734-1740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical