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General NPI Number Information
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NPI Number | 1053226951
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Entity Type | Individual
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Provider Name | TRISTIN ELLIOTT LMSW
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Gender | Male
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 5800 SOUTHLAND DR
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City | MOBILE
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State | AL
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Zip | 36693-3313
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Country | US
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Telephone | 251-661-0153
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Fax |
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Provider Business Mailing Address
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Address Line | 1172 JACKSON COUNTY LINE RD
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City | LUCEDALE
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State | MS
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Zip | 39452-4007
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Country | US
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Telephone | 251-307-4525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7597G
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License Number State | AL
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