Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. DIANE ELLABORN, MSW, LICSW
Active Sole ProprietorMS. DIANE ELLABORN, MSW, LICSW is a Clinical Social Worker healthcare provider located in PROSPECT HARBOR, Maine. NPI 1124109459 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · PROSPECT HARBOR, ME
Registration Details
- NPI Number
- 1124109459
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 17, 2006 (19.783419107216 yrs)
- Last Updated
- Sep 5, 2023
- Licenses
-
104732 (MA)LICSW104732 (MA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
173 MAIN STREETPROSPECT HARBOR, ME, 046690067Browse ME providers · Browse ZIP 04669
- Phone
- 5083611751
- Fax
- 2079639175
- Primary Specialty
-
Clinical Social Worker
1041C0700X
- Additional Specialty
- Clinical Social Worker
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.