Healthcare Provider Details

I. General information

NPI: 1972214302
Provider Name (Legal Business Name): ELIZABETH OLON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 N LEWIS RD STE 200
ROYERSFORD PA
19468-4323
US

IV. Provider business mailing address

826 N LEWIS RD STE 200
ROYERSFORD PA
19468-4323
US

V. Phone/Fax

Practice location:
  • Phone: 484-366-1371
  • Fax:
Mailing address:
  • Phone: 484-366-1371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW024539
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: