Provider Demographics
NPI:1366793119
Name:LECATES, ELIZABETH J (LCSW-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:LECATES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:PENNY
Other - Middle Name:
Other - Last Name:LECATES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:6419 MARY JANE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-1729
Mailing Address - Country:US
Mailing Address - Phone:302-236-3643
Mailing Address - Fax:410-543-2217
Practice Address - Street 1:1201 PEMBERTON DRIVE
Practice Address - Street 2:PEMBERTON BUSINESS CENTER SUITE 1B
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:302-236-3643
Practice Address - Fax:410-543-2217
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical