Provider Demographics
NPI:1215509146
Name:ELLIOTT, EMMA (LCSW)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
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:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-3475
Mailing Address - Fax:870-301-2092
Practice Address - Street 1:8 N RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9430
Practice Address - Country:US
Practice Address - Phone:501-470-9780
Practice Address - Fax:501-470-9785
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker