Provider Demographics
NPI:1184833287
Name:LOUGHLIN, M ELAINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:M
Middle Name:ELAINE
Last Name:LOUGHLIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:M
Other - Middle Name:ELAINE
Other - Last Name:LOUGHLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:129 W LINN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1639
Mailing Address - Country:US
Mailing Address - Phone:360-643-3589
Mailing Address - Fax:
Practice Address - Street 1:101 E BEAVER AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4922
Practice Address - Country:US
Practice Address - Phone:360-643-3589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0176771041C0700X
WA000058971041C0700X
WALF00001407106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist