Healthcare Provider Details

I. General information

NPI: 1740248418
Provider Name (Legal Business Name): ELIZABETH DELANEY LCSW, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 HILLSDALE AVE
GREENCASTLE IN
46135-1340
US

IV. Provider business mailing address

PO BOX 4323
TERRE HAUTE IN
47804-0323
US

V. Phone/Fax

Practice location:
  • Phone: 765-653-1024
  • Fax: 765-653-4931
Mailing address:
  • Phone: 812-231-8323
  • Fax: 812-231-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34002691
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: