Provider Demographics
NPI:1629864582
Name:PHILLIPS, ELIANA
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:NC
Mailing Address - Zip Code:27208-0087
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 87
Practice Address - Street 2:
Practice Address - City:BENNETT
Practice Address - State:NC
Practice Address - Zip Code:27208-0087
Practice Address - Country:US
Practice Address - Phone:919-548-7656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker