Provider Demographics
NPI:1194346353
Name:AYINDE, ELAINE (LMSW)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:AYINDE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16534
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-6534
Mailing Address - Country:US
Mailing Address - Phone:832-630-6391
Mailing Address - Fax:
Practice Address - Street 1:7718 DEEP GREEN DR
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77469-4672
Practice Address - Country:US
Practice Address - Phone:832-630-6391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57373104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker