Provider Demographics
NPI:1801127287
Name:MCELMOYLE, LORI-ANNE TROILO (LICSW)
Entity type:Individual
Prefix:MRS
First Name:LORI-ANNE
Middle Name:TROILO
Last Name:MCELMOYLE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1010 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2600
Mailing Address - Country:US
Mailing Address - Phone:617-534-3134
Mailing Address - Fax:617-534-2611
Practice Address - Street 1:1226 COLUMBIA RD # A
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-3978
Practice Address - Country:US
Practice Address - Phone:917-534-9500
Practice Address - Fax:617-534-9515
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213485104100000X
MA1213921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker