Provider Demographics
NPI:1528388451
Name:ROLETT, ELIAS DAVID (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ELIAS
Middle Name:DAVID
Last Name:ROLETT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 OLD BREVARD RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-0012
Mailing Address - Country:US
Mailing Address - Phone:828-667-0555
Mailing Address - Fax:828-667-8444
Practice Address - Street 1:34 OLD BREVARD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-0012
Practice Address - Country:US
Practice Address - Phone:828-667-0555
Practice Address - Fax:828-667-8444
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0033831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical