Provider Demographics
NPI:1730823253
Name:ESTEEM THERAPY LLC
Entity type:Organization
Organization Name:ESTEEM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYEAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSSEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:985-817-8170
Mailing Address - Street 1:429 W. AIRLINE HWY
Mailing Address - Street 2:SUITE Q, OFFICE #5
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068
Mailing Address - Country:US
Mailing Address - Phone:985-210-0789
Mailing Address - Fax:985-331-7771
Practice Address - Street 1:429 W. AIRLINE HWY
Practice Address - Street 2:SUITE Q, OFFICE #5
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068
Practice Address - Country:US
Practice Address - Phone:985-210-0789
Practice Address - Fax:985-331-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty