Provider Demographics
NPI:1336460906
Name:CRONIN, ELAINE S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:S
Last Name:CRONIN
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 1:711 N 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7131
Mailing Address - Country:US
Mailing Address - Phone:954-983-0212
Mailing Address - Fax:
Practice Address - Street 1:711 N 73RD AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-7131
Practice Address - Country:US
Practice Address - Phone:954-983-0212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW64641041C0700X
FLDOE 3806751041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool