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General NPI Number Information
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NPI Number | 1326935479
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Entity Type | Individual
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Provider Name | ELAYNA CANTRELL
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Gender | Female
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 5101 E US HIGHWAY 36
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City | AVON
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State | IN
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Zip | 46123-6645
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Country | US
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Telephone | 888-714-1927
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Fax |
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Provider Business Mailing Address
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Address Line | 1349 ECHO BEND ST
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City | GREENWOOD
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State | IN
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Zip | 46142-1116
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Country | US
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Telephone | 317-694-8324
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 000036486
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33012818A
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License Number State | IN
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