Provider Demographics
NPI:1467485136
Name:NELL, ELAINE TURK (LCSW, ACSW)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:TURK
Last Name:NELL
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:TURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 CINNAMON WAY
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-7260
Mailing Address - Country:US
Mailing Address - Phone:336-764-9322
Mailing Address - Fax:
Practice Address - Street 1:4208 SIX FORKS RD
Practice Address - Street 2:BLDG 1, SUITE 305A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5735
Practice Address - Country:US
Practice Address - Phone:800-632-6074
Practice Address - Fax:866-341-7509
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0051191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2850393Medicare ID - Type UnspecifiedMEDICARE WITH PARADIGM