Provider Demographics
NPI:1073267357
Name:ELLIOTT, DAPHNE (LCSW)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 LONG PIER LN UNIT 205
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-7735
Mailing Address - Country:US
Mailing Address - Phone:919-394-0490
Mailing Address - Fax:
Practice Address - Street 1:4951 LONG PIER LN UNIT 205
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-7735
Practice Address - Country:US
Practice Address - Phone:919-394-0490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health