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General NPI Number Information
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NPI Number | 1689730236
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Entity Type | Individual
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Provider Name | LETICIA S ELIAS LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 10500 SUMMIT AVE KAISER PERMANENTE SUMMIT BEHAVIORAL HEALTH CENTER
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City | KENSINGTON
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State | MD
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Zip | 20895-2422
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Country | US
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Telephone | 301-897-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 E JEFFERSON ST KAISER PERMANENTE MEDICARE ENROLLMENT
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City | ROCKVILLE
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State | MD
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Zip | 20852-4908
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Country | US
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Telephone | 301-816-2424
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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 | LCS21250
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50079093
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 17798
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License Number State | MD
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