Provider Demographics
NPI:1932981750
Name:MCDERMOTT, ELIZABETH MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:MCDERMOTT
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 1:318 CATCHPENNY LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5443
Mailing Address - Country:US
Mailing Address - Phone:484-832-3249
Mailing Address - Fax:
Practice Address - Street 1:8765 STENTON AVE
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-8317
Practice Address - Country:US
Practice Address - Phone:267-674-5035
Practice Address - Fax:215-836-2509
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0240851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical