Provider Demographics
NPI:1992378327
Name:ELLIOTT, EMILY (LISW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3999
Mailing Address - Country:US
Mailing Address - Phone:614-618-5955
Mailing Address - Fax:614-618-5956
Practice Address - Street 1:630 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3999
Practice Address - Country:US
Practice Address - Phone:614-618-5955
Practice Address - Fax:614-618-5956
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2106447104100000X, 1041C0700X
OHI.25067091041C0700X
OH25067091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker