1689031684 NPI number — ELIZABETH KATHARINE HELEN SCHNELZER LCSW

Table of content: ELIZABETH KATHARINE HELEN SCHNELZER LCSW (NPI 1689031684)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689031684 NPI number — ELIZABETH KATHARINE HELEN SCHNELZER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNELZER
Provider First Name:
ELIZABETH
Provider Middle Name:
KATHARINE HELEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHNELZER
Provider Other First Name:
LIZ
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1689031684
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
42835 BLUESTONE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROADLANDS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20148-5080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-354-0304
Provider Business Mailing Address Fax Number:
703-552-3025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43454 CROSSROADS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHBURN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20147-7778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-354-0304
Provider Business Practice Location Address Fax Number:
703-552-3025
Provider Enumeration Date:
01/21/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904004564 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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