Provider Demographics
NPI:1780028431
Name:NYMAN, ELIZABETH DENIS (LPC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:DENIS
Last Name:NYMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3288 CALUMET DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-7402
Mailing Address - Country:US
Mailing Address - Phone:318-458-4695
Mailing Address - Fax:318-688-7922
Practice Address - Street 1:8924 JEWELLA AVE
Practice Address - Street 2:ENTRANCE 1
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2100
Practice Address - Country:US
Practice Address - Phone:318-458-4695
Practice Address - Fax:318-688-7922
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional