Provider Demographics
NPI:1144744426
Name:EDINGTON, ELIZABETH III (MSSW, LSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:EDINGTON
Suffix:III
Gender:F
Credentials:MSSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2810
Mailing Address - Country:US
Mailing Address - Phone:937-296-1007
Mailing Address - Fax:
Practice Address - Street 1:1046 BROWN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2810
Practice Address - Country:US
Practice Address - Phone:937-296-1007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.15025971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical