Provider Demographics
NPI:1437735172
Name:CORE ELEMENTS LLC
Entity Type:Organization
Organization Name:CORE ELEMENTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER AND CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LADC, CCS
Authorized Official - Phone:207-318-2901
Mailing Address - Street 1:510 MAIN ST OFC 206
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1339
Mailing Address - Country:US
Mailing Address - Phone:207-318-2901
Mailing Address - Fax:207-222-0066
Practice Address - Street 1:510 MAIN ST OFC 206
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1339
Practice Address - Country:US
Practice Address - Phone:207-318-2901
Practice Address - Fax:207-222-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty