Provider Demographics
NPI:1376599894
Name:PILSON, ELIZABETH H (LCSW C)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:H
Last Name:PILSON
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:H
Other - Last Name:PILSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW C
Mailing Address - Street 1:7120 MINSTREL WAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045
Mailing Address - Country:US
Mailing Address - Phone:410-868-7431
Mailing Address - Fax:410-381-4711
Practice Address - Street 1:7120 MINSTREL WAY
Practice Address - Street 2:SUITE 203
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:410-868-7431
Practice Address - Fax:410-381-4711
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD090141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD522SMedicare UPIN