Provider Demographics
NPI:1104026301
Name:ELLIOT, HALLY B (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:HALLY
Middle Name:B
Last Name:ELLIOT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:HALLY
Other - Middle Name:
Other - Last Name:BARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 SUN TEMPLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758
Mailing Address - Country:US
Mailing Address - Phone:256-288-3333
Mailing Address - Fax:256-288-3334
Practice Address - Street 1:600 SUN TEMPLE DRIVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758
Practice Address - Country:US
Practice Address - Phone:256-288-3333
Practice Address - Fax:256-288-3334
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker