Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 114935 | MA |
NPI | 1003056672 |
---|---|
Provider Name | Stephen H Elkin |
First Address | Sharon, MA 02067-1172 |
Second Address | Sharon, MA 02067-1172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2009 |
Last Update Date | 19/05/2011 |