Provider Demographics
NPI:1902826332
Name:ELSOM, DIANNE EMORY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:EMORY
Last Name:ELSOM
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 1:2312 SCOTLAND RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-7960
Mailing Address - Country:US
Mailing Address - Phone:717-267-2081
Mailing Address - Fax:717-267-2740
Practice Address - Street 1:2312 SCOTLAND RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-7960
Practice Address - Country:US
Practice Address - Phone:717-267-2081
Practice Address - Fax:717-267-2740
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0153901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical