Provider Demographics
NPI:1306505946
Name:COMER, ELIZABETH AUDREY (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:AUDREY
Last Name:COMER
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 1:733 CABIN HILL DR APT 2C
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1691
Mailing Address - Country:US
Mailing Address - Phone:724-880-0740
Mailing Address - Fax:
Practice Address - Street 1:130 WOODLAND CT STE 1
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-9383
Practice Address - Country:US
Practice Address - Phone:724-880-0740
Practice Address - Fax:724-603-3335
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-10
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW022653104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker