Individual
ELIZABETH A AGUAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
119 BROADWAY STE 108, CHESTERTON, IN 46304-2477
(219) 433-3741
Mailing address
436 SPRING CANYON DR, HEBRON, IN 46341-8627
(219) 433-3741
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001144A
IN
1041C0700X
Clinical Social Worker
Primary
34006074A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
651990045
IN MEDICARE
IN
01
—
P01951856
RAILROAD MEDICARE
IN
Enumeration date
12/28/2005
Last updated
10/13/2023
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