Provider Demographics
NPI:1043304827
Name:ELIZABETH W. HORTON, MSW, LTD.
Entity Type:Organization
Organization Name:ELIZABETH W. HORTON, MSW, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-702-8631
Mailing Address - Street 1:3131 EXCELSIOR BLVD
Mailing Address - Street 2:#306
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4600
Mailing Address - Country:US
Mailing Address - Phone:612-702-8631
Mailing Address - Fax:612-920-6957
Practice Address - Street 1:3131 EXCELSIOR BLVD
Practice Address - Street 2:#306
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-4600
Practice Address - Country:US
Practice Address - Phone:612-702-8631
Practice Address - Fax:612-920-6957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00201261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)