Provider Demographics
NPI:1013950161
Name:ELLIOT, NANCY W (LPC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:W
Last Name:ELLIOT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 S CLACK ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1557
Mailing Address - Country:US
Mailing Address - Phone:325-690-5131
Mailing Address - Fax:325-690-5228
Practice Address - Street 1:2626 S CLACK ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-1557
Practice Address - Country:US
Practice Address - Phone:325-690-5131
Practice Address - Fax:325-690-5228
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14842101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095846402Medicaid