Provider Demographics
NPI:1275077216
Name:PATRICK, ELIZABETH R (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:PATRICK
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 1:207 W MILLBROOK RD STE 210 #2014
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4490
Mailing Address - Country:US
Mailing Address - Phone:919-505-1133
Mailing Address - Fax:
Practice Address - Street 1:207 W MILLBROOK RD STE 210
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4490
Practice Address - Country:US
Practice Address - Phone:919-505-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-09
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0130171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical