Diane Ellaborn is a Clinical in Prospect Harbor, Maine. Diane Ellaborn practices all healthcare services and medical treatments related to Clinical. The NPI Number for Diane Ellaborn is 1124109459. The last update date is 2023-09-05.
Diane Ellaborn's current location address is P.o. Box 67, Prospect Harbor, Maine. You can contact this provider via phone number 5083611751 and fax number 2079639175. The mailing address for Diane Ellaborn is P.o. Box 67, Prospect Harbor, Maine. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Diane Ellaborn |
|---|---|
| Address | P.o. Box 67, Prospect Harbor, Maine |
| Phone Number | 5083611751 |
| Fax Number | 2079639175 |
| Sole Proprietor | Y |
| Credentials | MSW, LICSW |
NPI Number Detail
| NPI Number | 1124109459 |
|---|---|
| Provider Enumeration Date | 2006-10-17 |
| Last Updated Date | 2023-09-05 |
Provider Mailing Address Detail
| Address | P.o. Box 67 |
|---|---|
| City | Prospect Harbor |
| State | Maine (ME) |
| Post Code | 46690067 |
| Phone Number | 5083611751 |
| Fax Number | 2079639175 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 104732 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 31285 | MA | -- | |
| 304462 | MA | MAGELLAN | |
| 140670 | MA | VALUE OPTIONS | |
| P03867 | MA | BCBS | |
| 1012390 | BEACON | ||
| 1890352 | MA | -- | |
| 118190 | MA | BHN | |
| 6200635 | MA | UBH | |
| 767846 | MA | TUFTS |
Post Comment/ Review Below
What is the unique identifier code issued to Diane Ellaborn by the Centers for Medicare & Medicaid Services?
The Diane Ellaborn has been assigned the NPI (National Provider Identifier) 1124109459. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Diane Ellaborn's facilities are geographically located?
The facilities of Diane Ellaborn are physically situated at the following location: P.O. Box 67, Prospect Harbor, ME, 46690067.
What is the area of specialization for Diane Ellaborn, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Diane Ellaborn is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
When was the Diane Ellaborn's 1124109459 issued?
The Diane Ellaborn's 1124109459 was issued on 2006-10-17.
When was the information pertaining to Diane Ellaborn most recently updated or revised?
The details related to Diane Ellaborn, including its address, specialty, and other relevant information, were last updated or revised on 2023-09-05.
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