Provider Demographics
NPI:1144772930
Name:ELMA, LINDA S (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:ELMA
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 1:1999 NW 136TH AVE
Mailing Address - Street 2:APT 561
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-5370
Mailing Address - Country:US
Mailing Address - Phone:786-237-5165
Mailing Address - Fax:
Practice Address - Street 1:11601 BISCAYNE BLVD STE 303
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3151
Practice Address - Country:US
Practice Address - Phone:954-278-0487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW172571041C0700X
FLISW11128103K00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst