Provider Demographics
NPI:1407122286
Name:ELROD, SHIRLEY JEAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:ELROD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 RISING SUN RD
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18969-2125
Mailing Address - Country:US
Mailing Address - Phone:215-362-0932
Mailing Address - Fax:
Practice Address - Street 1:3847 SKIPPACK PIKE
Practice Address - Street 2:
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474-1299
Practice Address - Country:US
Practice Address - Phone:610-222-4110
Practice Address - Fax:610-222-4116
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000192106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist