Provider Demographics
NPI:1144681271
Name:ELEBY, LASONJA MONIQUE
Entity type:Individual
Prefix:DR
First Name:LASONJA
Middle Name:MONIQUE
Last Name:ELEBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 NORLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-3944
Mailing Address - Country:US
Mailing Address - Phone:504-205-0148
Mailing Address - Fax:
Practice Address - Street 1:2550 BELLE CHASSE HWY STE 220
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-6733
Practice Address - Country:US
Practice Address - Phone:504-367-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7474101YP2500X, 171M00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health