Doctor Name: | MR. JEFFREY DENNIS ELLIOTT |
NPI Number: | 1033259122 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, TLSW, CCAC |
License Number: | 06-300 |
Business Practice Address: | 2121 7th St Parkersburg, WV - 261013803 |
Business Phone Number: | 3044841721 |
Business Fax Number: | 3044856710 |
Mailing Address: | 12 Worthington Ln, PARKERSBURG |
State: | WV |
Postal Code: | 261041500 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 06-300 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |