Audrey Elliott
Individual provider Active NPI Social Worker · Columbia, IL
NPI 1700524238 · NPPES record last updated May 24, 2022
Key facts
- NPI
- 1700524238
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 216 W Sand Bank Rd Ste 14
Columbia, IL 62236-1084 - Phone
- (618) 281-2307
- NPI assigned
- May 24, 2022
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
216 W Sand Bank Rd Ste 14
Columbia, IL 62236-1084
Mailing address
75 Winter Valley Dr
Fenton, MO 63026-4861
Other providers in Columbia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.