Provider Demographics
NPI:1093341117
Name:ELKS THERAPY
Entity Type:Organization
Organization Name:ELKS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KEIP-STRAUSBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-290-7730
Mailing Address - Street 1:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:FL
Mailing Address - Zip Code:32462-0024
Mailing Address - Country:US
Mailing Address - Phone:570-810-9505
Mailing Address - Fax:850-800-9059
Practice Address - Street 1:2549 DAVIDS RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:FL
Practice Address - Zip Code:32462-3178
Practice Address - Country:US
Practice Address - Phone:570-810-9505
Practice Address - Fax:850-800-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health