Provider Demographics
NPI:1710028451
Name:MCELROY, CATHY DAVIDSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:DAVIDSON
Last Name:MCELROY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ASHWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-8900
Mailing Address - Country:US
Mailing Address - Phone:973-663-6204
Mailing Address - Fax:843-347-6258
Practice Address - Street 1:110 ASHWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8900
Practice Address - Country:US
Practice Address - Phone:973-663-6204
Practice Address - Fax:843-347-6258
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046915001041C0700X
NCC0049541041C0700X
SC87741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
084548Medicare ID - Type Unspecified