Elizabeth Love McGillivray, LCSW

Individual provider Active NPI Clinical Social Worker · Pontotoc, MS

NPI 1407299209 · NPPES record last updated Sep 2, 2014

Key facts

NPI
1407299209
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C7370 (MS)
Practice address
356 E Oxford St
Pontotoc, MS 38863-2314
Phone
(662) 296-1040
NPI assigned
Apr 10, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C7370MSMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C7370 MS Yes

Addresses

Primary practice location

356 E Oxford St
Pontotoc, MS 38863-2314

Mailing address

356 E Oxford St.
Pontotoc, MS 38863
Phone (662) 296-1040

Other providers in Pontotoc, MS

All providers in Pontotoc, MS · Clinical Social Worker in Mississippi

Sources for this page

Verify at the official NPI Registry.