Provider Demographics
NPI:1083749428
Name:ELMS, JEMA JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEMA
Middle Name:JEAN
Last Name:ELMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JEMA
Other - Middle Name:JEAN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1625 VILLAGE TRL
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5435
Mailing Address - Country:US
Mailing Address - Phone:682-214-1228
Mailing Address - Fax:
Practice Address - Street 1:1625 VILLAGE TRL
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-5435
Practice Address - Country:US
Practice Address - Phone:682-214-1228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX539321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical