Provider Demographics
NPI:1881820991
Name:DILL, ELAINE THERESA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:THERESA
Last Name:DILL
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:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:PLUCKEMIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07978-0168
Mailing Address - Country:US
Mailing Address - Phone:908-490-1923
Mailing Address - Fax:908-490-1923
Practice Address - Street 1:254 ROUTE 202-206
Practice Address - Street 2:
Practice Address - City:PLUCKEMIN
Practice Address - State:NJ
Practice Address - Zip Code:07978
Practice Address - Country:US
Practice Address - Phone:908-490-1923
Practice Address - Fax:908-490-1923
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC049740001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical