Provider Demographics
NPI:1922300730
Name:DALEY, ELIZABETH JANE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JANE
Last Name:DALEY
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 1:154 KELLEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-3411
Mailing Address - Country:US
Mailing Address - Phone:207-460-4190
Mailing Address - Fax:
Practice Address - Street 1:154 KELLEY POINT RD
Practice Address - Street 2:
Practice Address - City:JONESPORT
Practice Address - State:ME
Practice Address - Zip Code:04649-3411
Practice Address - Country:US
Practice Address - Phone:207-460-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC142031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical