Provider Demographics
NPI:1932564341
Name:MICHEL, ELLEN (LPC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 ENGLISH OAK DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3181
Mailing Address - Country:US
Mailing Address - Phone:504-813-8894
Mailing Address - Fax:985-303-2763
Practice Address - Street 1:2000 PRESERVE LAKE DR STE D
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5340
Practice Address - Country:US
Practice Address - Phone:985-205-1441
Practice Address - Fax:985-303-2763
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1548839Medicaid