Provider Demographics
NPI:1992464853
Name:ELSTON, KATHERINE L
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:ELSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:LAYNE
Other - Last Name:ELSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RBT
Mailing Address - Street 1:1964 ASHLEY RIVER RD UNIT 80901B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29416-1637
Mailing Address - Country:US
Mailing Address - Phone:919-923-7391
Mailing Address - Fax:888-808-4249
Practice Address - Street 1:1964 ASHLEY RIVER RD
Practice Address - Street 2:UNIT 80901B
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29416
Practice Address - Country:US
Practice Address - Phone:919-923-7391
Practice Address - Fax:888-808-4249
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician