Provider Demographics
NPI:1720697915
Name:ELDER, PATRICIA (LMFT, LMHC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ELDER
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 CLEMATIS ST UNIT 2474
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33402-5104
Mailing Address - Country:US
Mailing Address - Phone:561-377-2373
Mailing Address - Fax:
Practice Address - Street 1:3626 WHITEHALL DR APT 206
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1065
Practice Address - Country:US
Practice Address - Phone:561-377-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17486101YM0800X
FLMT3726106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health