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NPI Code Detail

MEDICARE: ELIZABETH HUBBARD LICSW

MEDICARE:   ELIZABETH  HUBBARD  LICSW
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
11041C0700XClinical Social WorkerLW61341356WA

General Provider Information

NPI Number : 1902655095
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH HUBBARD LICSW
Provider Business Mailing Address
First Line : 4900 DECEPTION CIR
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-9707
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4900 DECEPTION CIR
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-9707
Country : US
Telephone Number : 910-978-5805
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2024
Last Update Date : 05/13/2024

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Directions to “ ELIZABETH HUBBARD LICSW” Practice Location

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