Provider Demographics
NPI:1902679582
Name:PELLEGRIN, PAIGE MCELROY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MCELROY
Last Name:PELLEGRIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:ELIZABETH
Other - Last Name:MCELROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 MENARD DR
Mailing Address - Street 2:
Mailing Address - City:BOURG
Mailing Address - State:LA
Mailing Address - Zip Code:70343-3631
Mailing Address - Country:US
Mailing Address - Phone:985-804-2112
Mailing Address - Fax:
Practice Address - Street 1:720 VERRET ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4634
Practice Address - Country:US
Practice Address - Phone:985-872-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional