Ebony Ellzey Allen, LCSW
Individual provider Active NPI Clinical Social Worker · Gretna, LA
NPI 1033770235 · NPPES record last updated Nov 12, 2019
Key facts
- NPI
- 1033770235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 12216 (LA)
- Practice address
- 1500 Lafayette St Ste 144
Gretna, LA 70053-5758 - Phone
- (504) 372-1810
- NPI assigned
- Jun 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230830000405 | LA | Practitioner - Clinical Social Worker | 9638532211 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12216 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brook Haven Counseling and Consulting Services, LLC | Clinical | Current |
Accepting new patients |
| Thrive Counseling LLC | Current |
Accepting new patients |
Locations
6560 Youree Dr
Ste 1003
Shreveport, LA 71105
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 12216 | LA | |
| Clinical Social Worker | 1041C0700X | 12216 | LA | Yes |
Addresses
Primary practice location
1500 Lafayette St Ste 144
Gretna, LA 70053-5758
Mailing address
2131 General Collins Ave
New Orleans, LA 70114-5027
Phone (504) 372-1810
Other providers in Gretna, LA
- Align Chiropractic, LLC
- Aligned Behavior Method, LLC
- All About You Transportation
- All Smiles Dental LLC
- Darius Michael Allen
- Gwendolyn Faye Allen
- Mark McLean Allen
- Alternative Care Consultants, LLC
- American Active Rehab Inc
- American Resource Technicians
All providers in Gretna, LA · Clinical Social Worker in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.