Provider Demographics
NPI:1316584097
Name:TUFFY, ELISA S (NCC)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:S
Last Name:TUFFY
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 LEACH HILL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1349
Mailing Address - Country:US
Mailing Address - Phone:570-591-1529
Mailing Address - Fax:570-319-1719
Practice Address - Street 1:3218 PITTSTON AVE STE 8
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-2964
Practice Address - Country:US
Practice Address - Phone:570-209-9898
Practice Address - Fax:570-319-1719
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health