Provider Demographics
NPI:1730858630
Name:EMILY ELMORE, LCSW, RYT, PLLC
Entity type:Organization
Organization Name:EMILY ELMORE, LCSW, RYT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-390-7416
Mailing Address - Street 1:3 GRANT SQ # 217
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3351
Mailing Address - Country:US
Mailing Address - Phone:217-390-7416
Mailing Address - Fax:
Practice Address - Street 1:1919 S HIGHLAND AVE STE 325A
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6181
Practice Address - Country:US
Practice Address - Phone:773-236-1337
Practice Address - Fax:773-688-1665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty