Elizabeth Christmas

Individual provider Active NPI Clinical Social Worker · Montgomery, IN

NPI 1154716827 · NPPES record last updated Mar 31, 2015

Key facts

NPI
1154716827
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
34005293A (IN)
Practice address
542 N 3Rd St
Montgomery, IN 47558-5745
Phone
(812) 486-2333
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
34005293AINMDClinical Social Worker

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19031/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005293A IN Yes

Addresses

Primary practice location

542 N 3Rd St
Montgomery, IN 47558-5745

Mailing address

542 N 3Rd St
Montgomery, IN 47558-5745
Phone (812) 486-2333

Other providers in Montgomery, IN

All providers in Montgomery, IN · Clinical Social Worker in Indiana

Sources for this page

Verify at the official NPI Registry.