MEDICARE: LAYKEN ELTZROTH CSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	260060	KY

General Provider Information

NPI Number	:	1841090016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAYKEN ELTZROTH CSW

Provider Business Mailing Address
First Line	:	10100 ELIDA RD
Second Line	:
City	:	DELPHOS
State	:	OH
Zip	:	45833-9056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 S HIGHWAY 27 STE 3
Second Line	:
City	:	SOMERSET
State	:	KY
Zip	:	42501-3124
Country	:	US
Telephone Number	:	606-679-1815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2025
Last Update Date	:	06/03/2026

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Directions to “ LAYKEN ELTZROTH CSW” Practice Location

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