Provider Demographics
NPI:1386358513
Name:ELMA, EMILY S (LISW-S, CDP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:S
Last Name:ELMA
Suffix:
Gender:F
Credentials:LISW-S, CDP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:S
Other - Last Name:HUTZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2965 KINGSLEY CT
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8209
Mailing Address - Country:US
Mailing Address - Phone:513-259-1778
Mailing Address - Fax:
Practice Address - Street 1:2965 KINGSLEY CT
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8209
Practice Address - Country:US
Practice Address - Phone:513-259-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.18009531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical