Provider Demographics
NPI:1861225633
Name:EDDINGTON, ELENA MARIE (LCSW-A)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:MARIE
Last Name:EDDINGTON
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 DEMERIUS ST APT P2
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1669
Mailing Address - Country:US
Mailing Address - Phone:225-620-8444
Mailing Address - Fax:
Practice Address - Street 1:7200 CREEDMOOR RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1710
Practice Address - Country:US
Practice Address - Phone:919-912-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0212241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical