Provider Demographics
NPI:1902515802
Name:MOUSER, ELIZABETH EMILY (MSW, CSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EMILY
Last Name:MOUSER
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1297 JACK SMITH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42274-9711
Mailing Address - Country:US
Mailing Address - Phone:270-529-1020
Mailing Address - Fax:
Practice Address - Street 1:809 19TH STREET
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965
Practice Address - Country:US
Practice Address - Phone:606-248-3042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2569281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical