Provider Demographics
NPI:1043701303
Name:ABBOTT, ELIZABETH IONE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:IONE
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1830
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-1830
Mailing Address - Country:US
Mailing Address - Phone:360-215-5270
Mailing Address - Fax:
Practice Address - Street 1:1229 CORNWALL AVE STE 311
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5023
Practice Address - Country:US
Practice Address - Phone:360-215-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW611141531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical