Provider Demographics
NPI:1528430675
Name:ELIE, LOUIS
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:ELIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 HERSEY D WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-5927
Mailing Address - Country:US
Mailing Address - Phone:318-990-3907
Mailing Address - Fax:
Practice Address - Street 1:2731 HERSEY D WILSON DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-5927
Practice Address - Country:US
Practice Address - Phone:318-990-3907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health