Provider Demographics
NPI:1073923314
Name:JERG, ELIZABETH KIM (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KIM
Last Name:JERG
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 S AUSTIN ST APT 504
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1958
Mailing Address - Country:US
Mailing Address - Phone:806-433-4535
Mailing Address - Fax:
Practice Address - Street 1:2028 S AUSTIN ST APT 504
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1958
Practice Address - Country:US
Practice Address - Phone:806-433-4535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX513921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical