Provider Demographics
NPI:1053750869
Name:ELLIOTT, CIBELE FC (LPC)
Entity type:Individual
Prefix:
First Name:CIBELE
Middle Name:FC
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 BAGNELL DAM BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65049-8716
Mailing Address - Country:US
Mailing Address - Phone:573-693-1119
Mailing Address - Fax:573-557-4163
Practice Address - Street 1:752 BAGNELL DAM BLVD STE B
Practice Address - Street 2:
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-8716
Practice Address - Country:US
Practice Address - Phone:573-693-1119
Practice Address - Fax:573-557-4163
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor