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General NPI Number Information
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NPI Number | 1598479040
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Entity Type | Individual
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Provider Name | PARIS ELROY HARDAMON LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 4936 S INDIANA AVE
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City | CHICAGO
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State | IL
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Zip | 60615-2109
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Country | US
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Telephone | 872-240-4229
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Fax |
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Provider Business Mailing Address
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Address Line | 3447 W 137TH STREET PO BOX 545
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City | ROBBINS
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State | IL
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Zip | 60472-0545
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.024980
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License Number State | IL
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