Individual
SCOTT CHARLES ELKERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1930 COON RAPIDS BLVD NW, FAMILY LIFE MENTAL HEALTH CENTER, COON RAPIDS, MN 55433-4708
(763) 427-7964
(763) 427-7976
Mailing address
1930 COON RAPIDS BLVD NW, FAMILY LIFE MENTAL HEALTH CENTER, COON RAPIDS, MN 55433-4708
(763) 427-7964
(763) 427-7976
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
897
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013103
PREFERRED ONE
MN
01
—
115670
UCARE
—
01
—
473R5EL
BCBS
MN
01
—
6252842
UBH
—
05
—
949318200
—
MN
01
—
HP21707
HEALTH PARTNERS
—
Enumeration date
04/05/2006
Last updated
12/10/2008
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