Provider Demographics
NPI:1174748461
Name:ELHARD, TIMOTHY NELSON (LCSW)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:NELSON
Last Name:ELHARD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 CARNES ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-5502
Mailing Address - Country:US
Mailing Address - Phone:214-754-9918
Mailing Address - Fax:214-754-9973
Practice Address - Street 1:3317 MCKINNEY AVE STE 205
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-0379
Practice Address - Country:US
Practice Address - Phone:214-754-9918
Practice Address - Fax:214-754-9973
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00S24ZMedicare ID - Type Unspecified