Provider Demographics
NPI:1407554777
Name:ELAINA HERNANDEZ, LCSW, PLLC
Entity Type:Organization
Organization Name:ELAINA HERNANDEZ, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELAINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-386-9852
Mailing Address - Street 1:4007 CAROLINA LILY ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6711
Mailing Address - Country:US
Mailing Address - Phone:646-548-6398
Mailing Address - Fax:
Practice Address - Street 1:1140 KILDAIRE FARM RD STE 200-5
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4562
Practice Address - Country:US
Practice Address - Phone:919-386-9852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty