Provider Demographics
NPI:1922597392
Name:DUPREE, ELISABETH SIMONE (LCSW, MCAP)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:SIMONE
Last Name:DUPREE
Suffix:
Gender:F
Credentials:LCSW, MCAP
Other - Prefix:
Other - First Name:ELLE
Other - Middle Name:SIMONE
Other - Last Name:DUPREE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:521 LAKE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3847
Mailing Address - Country:US
Mailing Address - Phone:561-909-7679
Mailing Address - Fax:
Practice Address - Street 1:521 LAKE AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-3847
Practice Address - Country:US
Practice Address - Phone:561-909-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW136111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty