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1487260725 NPI number — ELIZABETH ANNE CORTEZ LICSW

NPI Number: 1487260725
Health Care Provider/Practitioner: ELIZABETH ANNE CORTEZ LICSW

Information about “1487260725” NPI (ELIZABETH ANNE CORTEZ LICSW) exists in 1487260725 in HTML format HTML  |  1487260725 in plain Text format TXT  |  1487260725 in PDF (Portable Document Format) PDF  |  1487260725 in an XML format XML  formats.

NPI Number : 1487260725 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487260725",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CORTEZ",
    "FirstName": "ELIZABETH",
    "MiddleName": "ANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LICSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2764 PLEASANT RD STE A",
    "SecondLineMailingAddress": "PMB 10354",
    "MailingAddressCityName": "FORT MILL",
    "MailingAddressStateName": "SC",
    "MailingAddressPostalCode": "29708-7214",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "803-964-9781",
    "MailingAddressFaxNumber": "803-784-8971",
    "FirstLinePracticeLocationAddress": "6650 RIVERS AVE STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORTH CHARLESTON",
    "PracticeLocationAddressStateName": "SC",
    "PracticeLocationAddressPostalCode": "29406-4809",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "803-964-9781",
    "PracticeLocationAddressFaxNumber": "803-784-8971",
    "EnumerationDate": "09/22/2020",
    "LastUpdateDate": "11/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "LW61525542",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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