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NPI Code Detail

MEDICARE: WINONA ELROD LCSW

MEDICARE: WINONA ELROD 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1902372774
Entity Type Code : Organization
Provider Name (Legal Business Name) : WINONA ELROD LCSW
Provider Business Mailing Address
First Line : 1218 STONE ST STE 110
Second Line :
City : JONESBORO
State : AR
Zip : 72401-4568
Country : US
Telephone Number : 870-316-0688
Fax Number : 870-910-0550
Provider Business Practice Location Address
First Line : 1218 STONE ST STE 110
Second Line :
City : JONESBORO
State : AR
Zip : 72401-4568
Country : US
Telephone Number : 870-316-0688
Fax Number : 870-910-0550
Authorized Official
Title or Position : OWNER
Name : WINONA DERRICK ELROD
Credential : LCSW
Telephone Number : 870-316-0688
Provider Enumeration Date : 10/19/2018
Last Update Date : 03/03/2026

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Directions to “WINONA ELROD LCSW ” Practice Location

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