Individual
ELYCE ELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAAT, CADAC IV, LCAC
Contact information
Practice address
602 SANDERS ST, INDIANAPOLIS, IN 46203-1853
(317) 536-7100
(317) 536-7101
Mailing address
602 SANDERS ST, INDIANAPOLIS, IN 46203-1853
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12313276
CAQH
IN
01
—
87000024A
LCAC
IN
Enumeration date
05/01/2012
Last updated
05/01/2012
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