Provider Demographics
NPI:1528354636
Name:ELLIOTT, LAURA DILEO (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DILEO
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10176 CORPORATE SQUARE DR
Mailing Address - Street 2:SUITE 100-S
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-2924
Mailing Address - Country:US
Mailing Address - Phone:314-991-0100
Mailing Address - Fax:
Practice Address - Street 1:10176 CORPORATE SQUARE DR
Practice Address - Street 2:SUITE 100-S
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-2924
Practice Address - Country:US
Practice Address - Phone:314-991-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130278931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical