Provider Demographics
NPI:1841931912
Name:SPANO, ELANNA (LPC)
Entity type:Individual
Prefix:
First Name:ELANNA
Middle Name:
Last Name:SPANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 TRUMBULL DR APT 1
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5102
Mailing Address - Country:US
Mailing Address - Phone:201-304-5934
Mailing Address - Fax:
Practice Address - Street 1:31 TRUMBULL DR APT 1
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5102
Practice Address - Country:US
Practice Address - Phone:201-304-5934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00833600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional