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Individual
TINA MARIE ELLIOTT
Active
Individual
TINA MARIE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33009565A
IN
1041C0700X
Clinical Social Worker
Primary
34010409A
IN
1041C0700X
Clinical Social Worker
6801118992
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801118992
MASTERS SOCIAL WORKER LICENSE CLINICAL
MI
Enumeration date
02/06/2020
Last updated
02/12/2025
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