Individual
ELAINE MARIE SUPRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1792 BEAR CREEK PIKE, COLUMBIA, TN 38401-7653
(256) 452-1404
Mailing address
84 EASTWOOD DR, ANNISTON, AL 36207-9303
(256) 452-1404
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
4033C
AL
1041C0700X
Clinical Social Worker
Primary
6606
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6606
TENNESSEE LICENSE NUMBER
TN
Enumeration date
03/15/2019
Last updated
10/09/2025
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