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NPI Code Detail

MEDICARE: ELISSA REFSDAL LCSW, CADC-II

MEDICARE: ELISSA REFSDAL LCSW, CADC-II
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
1101YM0800XMental Health Counselor
2104100000XSocial Worker78542CA
31041C0700XClinical Social Worker

General Provider Information

NPI Number : 1912366485
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISSA REFSDAL LCSW, CADC-II
Provider Business Mailing Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number : 530-644-2412
Fax Number :
Provider Business Practice Location Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number : 530-644-2412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2016
Last Update Date : 12/02/2025

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