| Eleanor Health Professional La, Llc | |
|
3975 Oneal Ln Ste B Baton Rouge LA 70816-9105 | |
| (225) 267-9792 | |
| Not Available |
| Full Name | Eleanor Health Professional La, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3975 Oneal Ln Ste B, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Nzinga Ajabu Harrison (CHIEF MEDICAL OFFICER & OWNER) |
| Authorized Official Contact | 6174190858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eleanor Health Professional La, Llc 221 Crescent St Ste 202 Waltham MA 02453-3425 Ph: (866) 853-6162 | Eleanor Health Professional La, Llc 3975 Oneal Ln Ste B Baton Rouge LA 70816-9105 Ph: (225) 267-9792 |
| NPI Number | 1265050736 |
|---|---|
| Provider Enumeration Date | 07/10/2020 |
| Last Update Date | 02/10/2021 |
| Certification Date | 02/10/2021 |
| Medicare PECOS PAC ID | 4587070008 |
|---|---|
| Medicare Enrollment ID | O20210309000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265050736 | NPI | - | NPPES |
| Provider Name | Monique Pierre Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588184220 PECOS PAC ID: 6507130341 Enrollment ID: I20170918003240 |
| Provider Name | Richelle Van Buren-walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871898437 PECOS PAC ID: 6507127784 Enrollment ID: I20180305000527 |
| Provider Name | Marcus A Bachhuber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275820797 PECOS PAC ID: 0446400170 Enrollment ID: I20181219001815 |
| Provider Name | Felicia Latice Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750844494 PECOS PAC ID: 1951635291 Enrollment ID: I20190620001520 |
| Provider Name | Jadebrey Vyshette Kennon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518574441 PECOS PAC ID: 1951721307 Enrollment ID: I20201023001167 |
| Provider Name | Sauntrice O'quin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194246686 PECOS PAC ID: 3870850563 Enrollment ID: I20201118000548 |
| Provider Name | Julie Insyxiengmay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780272328 PECOS PAC ID: 8820404387 Enrollment ID: I20210308001498 |
| Provider Name | Nzinga Ajabu Harrison |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1518099910 PECOS PAC ID: 5698793875 Enrollment ID: I20210309000700 |
| Provider Name | Stephen William North |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073611091 PECOS PAC ID: 3476527300 Enrollment ID: I20210324002429 |
| Provider Name | Brittany Willard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952995193 PECOS PAC ID: 4486061504 Enrollment ID: I20210407001634 |
| Provider Name | Paula Vanessa B De La Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114088697 PECOS PAC ID: 3678541315 Enrollment ID: I20210525002816 |
| Provider Name | Alice A Roque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285237552 PECOS PAC ID: 2769882091 Enrollment ID: I20210608002762 |
| Provider Name | Tiffany E Arnold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457713869 PECOS PAC ID: 4789977067 Enrollment ID: I20220929001343 |
| Provider Name | Tina Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609448703 PECOS PAC ID: 2264808138 Enrollment ID: I20221018000602 |
| Provider Name | Brianne Faye Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225768724 PECOS PAC ID: 7517330970 Enrollment ID: I20230306001062 |
| Provider Name | Crystal Ann Randolph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811463797 PECOS PAC ID: 3072924463 Enrollment ID: I20240412003966 |
| Provider Name | Alexia Davida Montague |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962929679 PECOS PAC ID: 6800236530 Enrollment ID: I20240826002112 |
| Provider Name | Virmarie Diaz Fernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306248075 PECOS PAC ID: 8628499506 Enrollment ID: I20240906001617 |
| Provider Name | Andrew William Runkle |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1134211881 PECOS PAC ID: 2769468271 Enrollment ID: I20240917004334 |
| Provider Name | Rewa Banks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134595416 PECOS PAC ID: 2264729953 Enrollment ID: I20240925001733 |
| Provider Name | Jalessa Shanice Cherry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013447960 PECOS PAC ID: 3870909419 Enrollment ID: I20240930003552 |
| Provider Name | Colleen Hannush |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669648515 PECOS PAC ID: 2163561069 Enrollment ID: I20241002004072 |
| Provider Name | Bret Damon Kirson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861700676 PECOS PAC ID: 8921341280 Enrollment ID: I20241011001000 |
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