Provider Demographics
NPI:1376350488
Name:HORNE, ELIZABETH K (LCWSA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:HORNE
Suffix:
Gender:F
Credentials:LCWSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 HOLLYRIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3111
Mailing Address - Country:US
Mailing Address - Phone:919-323-5403
Mailing Address - Fax:
Practice Address - Street 1:7025 KIT CREEK RD BLDG 5
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-9741
Practice Address - Country:US
Practice Address - Phone:919-323-5403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0215661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical