Provider Demographics
NPI:1952183568
Name:ORMISTON, ERIN BAZZELL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:BAZZELL
Last Name:ORMISTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10933 CORNERSTONE PL
Mailing Address - Street 2:
Mailing Address - City:KEITHVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71047-8587
Mailing Address - Country:US
Mailing Address - Phone:318-415-9299
Mailing Address - Fax:
Practice Address - Street 1:1041 CHINABERRY DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2438
Practice Address - Country:US
Practice Address - Phone:318-415-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA180951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical