Provider Demographics
NPI:1407499791
Name:ELODIE LLC
Entity Type:Organization
Organization Name:ELODIE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:843-608-8851
Mailing Address - Street 1:PO BOX 2651
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29484-2651
Mailing Address - Country:US
Mailing Address - Phone:843-608-8851
Mailing Address - Fax:
Practice Address - Street 1:810 TRAVELERS BLVD STE L2
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8260
Practice Address - Country:US
Practice Address - Phone:843-608-8851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-20
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC800OtherDANIELLE LARKINS / LPC