Provider Demographics
NPI:1821260381
Name:CLABORN, ELIZABETH JEAN (LISW, MSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JEAN
Last Name:CLABORN
Suffix:
Gender:F
Credentials:LISW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5276
Mailing Address - Country:US
Mailing Address - Phone:740-361-7734
Mailing Address - Fax:740-382-3713
Practice Address - Street 1:136 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-3704
Practice Address - Country:US
Practice Address - Phone:740-387-5210
Practice Address - Fax:740-382-3713
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00294741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical