Provider Demographics
NPI:1013951052
Name:ELKINS, ETHEL A (LCSW)
Entity type:Individual
Prefix:
First Name:ETHEL
Middle Name:A
Last Name:ELKINS
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 1:108 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-1540
Mailing Address - Country:US
Mailing Address - Phone:812-753-1039
Mailing Address - Fax:812-753-1122
Practice Address - Street 1:123 N MCCREARY ST
Practice Address - Street 2:
Practice Address - City:FORT BRANCH
Practice Address - State:IN
Practice Address - Zip Code:47648-1313
Practice Address - Country:US
Practice Address - Phone:812-753-1039
Practice Address - Fax:812-753-1122
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002277A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000381376OtherANTHEM PIN
IN371620615OtherTRICARE PIN
IN000000381376OtherANTHEM PIN