Provider Demographics
NPI:1164704417
Name:ELROD, MARTHA CRAWFORD (LICSW)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:CRAWFORD
Last Name:ELROD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:CRAWFORD
Other - Last Name:BRAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1757 CHURCH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1301
Mailing Address - Country:US
Mailing Address - Phone:845-518-5275
Mailing Address - Fax:
Practice Address - Street 1:1757 CHURCH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1301
Practice Address - Country:US
Practice Address - Phone:845-518-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1250041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical