Provider Demographics
NPI:1396476818
Name:HUNTER, ELIZABETH IVEY (LCSWA)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:IVEY
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2332 KINGSBURY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6147
Mailing Address - Country:US
Mailing Address - Phone:704-589-8777
Mailing Address - Fax:
Practice Address - Street 1:3506 W TYVOLA RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-7201
Practice Address - Country:US
Practice Address - Phone:705-909-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0177321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical