Provider Demographics
NPI:1770661902
Name:NORTH, ELIZABETH M (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:NORTH
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 1:3408 WHIRL A WAY TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-1927
Mailing Address - Country:US
Mailing Address - Phone:303-519-9517
Mailing Address - Fax:
Practice Address - Street 1:2365 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4317
Practice Address - Country:US
Practice Address - Phone:303-519-9517
Practice Address - Fax:850-877-6968
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110341041C0700X, 101YM0800X
CO3541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical