Basic Information
| Provider Information | |||||||||
| NPI: | 1952492944 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCELMURRY-PATEL | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 VILLAGE PL | ||||||||
| Address2: | |||||||||
| City: | ZIONSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460773808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178733774 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2345 S LYNHURST DR | ||||||||
| Address2: | 205 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462418630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172478900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 08/06/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 33005097A | IN | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 34006538A | IN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.