Provider Demographics
NPI:1982956488
Name:KIMBERLY MCELROY
Entity Type:Organization
Organization Name:KIMBERLY MCELROY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCELROY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LAC
Authorized Official - Phone:985-209-4336
Mailing Address - Street 1:313 CHASE DR
Mailing Address - Street 2:
Mailing Address - City:BOURG
Mailing Address - State:LA
Mailing Address - Zip Code:70343-3647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 SECURITY BLVD STE F
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2780
Practice Address - Country:US
Practice Address - Phone:985-209-4336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1350251S00000X
LA4564251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health