Individual provider Active NPI

Preston W. Elder, LAC, CCS, SAP

  • Addiction (Substance Use Disorder) Counselor
  • Baton Rouge, LA
National Provider Identifier
1295134682
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
541 Issued in LA
Practice address
5319 Didesse Dr Ste D
Baton Rouge, LA 70808-6401
Phone
(225) 757-8044
Fax
(225) 757-8045
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 541 LA Primary

Addresses

Primary practice location

5319 Didesse Dr Ste D
Baton Rouge, LA 70808-6401

Mailing address

5319 Didesse Dr Ste D
Baton Rouge, LA 70808-6401
Phone (225) 757-8044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
541LAMDDental Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1295134682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 DIDESSE DR STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708086401",
            "telephone_number": "225-757-8044",
            "fax_number": "225-757-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 DIDESSE DR STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708086401",
            "telephone_number": "225-757-8044",
            "fax_number": "225-757-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "PRESTON",
        "middle_name": "W.",
        "credential": "LAC, CCS, SAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.