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Individual
ELIAS SIMON CHAMPI TELLO
Active
Individual
ELIAS SIMON CHAMPI TELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
Primary
LICSW1130506
MA
Other
Enumeration date
09/07/2017
Last updated
09/17/2026
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