Provider Demographics
NPI:1477091031
Name:WESTER, ELIZABETH (MSW, RCSWI)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WESTER
Suffix:
Gender:F
Credentials:MSW, RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 OLD PARSONAGE DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-6143
Mailing Address - Country:US
Mailing Address - Phone:321-419-9336
Mailing Address - Fax:
Practice Address - Street 1:505 BREVARD AVE
Practice Address - Street 2:STE 106
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7973
Practice Address - Country:US
Practice Address - Phone:321-632-5792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW49411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical