Provider Demographics
NPI:1023864535
Name:EBERTS, STEPHANIE ERIN (PHD, LPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ERIN
Last Name:EBERTS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E RIVER OAKS DRIVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815
Mailing Address - Country:US
Mailing Address - Phone:225-746-8870
Mailing Address - Fax:
Practice Address - Street 1:433 METAIRIE RD STE 502
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4343
Practice Address - Country:US
Practice Address - Phone:225-746-8870
Practice Address - Fax:225-308-6084
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6963101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor