Provider Demographics
NPI:1245777986
Name:DEMLER, ELIZABETH ANN MARIE (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN MARIE
Last Name:DEMLER
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 VILANA RDG APT 303
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4674
Mailing Address - Country:US
Mailing Address - Phone:919-961-9807
Mailing Address - Fax:
Practice Address - Street 1:1306 PADDOCK DR STE E100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4873
Practice Address - Country:US
Practice Address - Phone:919-790-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO111021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical