Provider Demographics
NPI:1194686378
Name:ELAM, DIAMOND (LPC)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:
Last Name:ELAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39307-4403
Mailing Address - Country:US
Mailing Address - Phone:773-331-4237
Mailing Address - Fax:
Practice Address - Street 1:3816 34TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39307-4403
Practice Address - Country:US
Practice Address - Phone:773-331-4237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-18
Last Update Date:2025-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional