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NPI Code Detail

MEDICARE: LOGAN ELIZABETH BOLIG MSW,LSW,LCSW

MEDICARE: LOGAN ELIZABETH BOLIG MSW,LSW,LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerSW140208PA
2104100000XSocial WorkerPA
31041C0700XClinical Social WorkerCW026899PA
4390200000XStudent in an Organized Health Care Education/Training Program31674836PA

General Provider Information

NPI Number : 1144997255
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOGAN ELIZABETH BOLIG MSW,LSW,LCSW
Provider Business Mailing Address
First Line : 40 DILWORTH ROAD
Second Line :
City : MILLERSVILLE
State : PA
Zip : 17551
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3601 CONCORD RD # A
Second Line :
City : YORK
State : PA
Zip : 17402-8741
Country : US
Telephone Number : 717-821-4438
Fax Number : 717-340-4232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2021
Last Update Date : 01/13/2026

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