Provider Demographics
NPI:1588717532
Name:DILLON, ELIZABETH E (MED)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:E
Last Name:DILLON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:D
Other - Last Name:ILLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:8002 KING HELIE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-1435
Mailing Address - Country:US
Mailing Address - Phone:727-841-4207
Mailing Address - Fax:
Practice Address - Street 1:8002 KING HELIE BLVD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-1435
Practice Address - Country:US
Practice Address - Phone:727-834-4300
Practice Address - Fax:727-834-3969
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11939101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL768051100Medicaid