Provider Demographics
NPI:1992026157
Name:MCELRATH, WANDA LYNNETTE (MSSW)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:LYNNETTE
Last Name:MCELRATH
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-8377
Mailing Address - Country:US
Mailing Address - Phone:910-673-2323
Mailing Address - Fax:910-673-2394
Practice Address - Street 1:241 GRANT ST
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-8377
Practice Address - Country:US
Practice Address - Phone:910-673-2323
Practice Address - Fax:910-673-2394
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0057461041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical