Provider Demographics
NPI:1255453080
Name:ROWE, ELANDERIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELANDERIA
Middle Name:
Last Name:ROWE
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 1:8751 COLLIN MCKINNEY STE 1102 # 1109
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6812
Mailing Address - Country:US
Mailing Address - Phone:469-885-3147
Mailing Address - Fax:
Practice Address - Street 1:8751 COLLIN MCKINNEY STE 1102 # 1109
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6812
Practice Address - Country:US
Practice Address - Phone:469-885-3147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341521041C0700X, 171M00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183007701Medicaid