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Organization
ELIZABETH BLALOCK, LCSW,PA
Active
Organization
ELIZABETH BLALOCK, LCSW,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH S BLALOCK LCSW (OWNER)
(704) 365-7777
Entity
Organization
Contact information
Practice address
6809 FAIRVIEW RD, CHARLOTTE, NC 28210-4195
(704) 365-7777
(704) 554-9682
Mailing address
6809 FAIRVIEW RD, CHARLOTTE, NC 28210-4195
(704) 365-7777
(704) 554-9682
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982641114
NPI
NC
Enumeration date
11/28/2017
Last updated
11/28/2017
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