Provider Demographics
NPI:1255950085
Name:CELLI, ELISE N (LMSW)
Entity type:Individual
Prefix:MS
First Name:ELISE
Middle Name:N
Last Name:CELLI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 CAMBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3933
Mailing Address - Country:US
Mailing Address - Phone:781-775-2784
Mailing Address - Fax:
Practice Address - Street 1:12242 BRITTANIA CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2583
Practice Address - Country:US
Practice Address - Phone:301-636-5182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-12
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD254611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical