Provider Demographics
NPI:1063836013
Name:ELDER, MISHA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:MISHA
Middle Name:
Last Name:ELDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MISHA
Other - Middle Name:
Other - Last Name:JAMALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:299 N EUCLID AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1470
Mailing Address - Country:US
Mailing Address - Phone:626-808-4600
Mailing Address - Fax:
Practice Address - Street 1:299 N EUCLID AVE STE 400
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1470
Practice Address - Country:US
Practice Address - Phone:626-808-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical