Provider Demographics
NPI:1417115130
Name:ELIAS, PATRICIA B (LAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:ELIAS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E SABROSA DR
Mailing Address - Street 2:
Mailing Address - City:NEW RIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-7941
Mailing Address - Country:US
Mailing Address - Phone:702-787-7985
Mailing Address - Fax:
Practice Address - Street 1:127 E SABROSA DR
Practice Address - Street 2:
Practice Address - City:NEW RIVER
Practice Address - State:AZ
Practice Address - Zip Code:85087-7941
Practice Address - Country:US
Practice Address - Phone:702-787-7985
Practice Address - Fax:702-940-9936
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health