Provider Demographics
NPI:1083299929
Name:DRAIN, ELIZABETH R (LPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:DRAIN
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 1:5050 POPLAR AVE STE 1118
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38157-1118
Mailing Address - Country:US
Mailing Address - Phone:901-683-5658
Mailing Address - Fax:
Practice Address - Street 1:5050 POPLAR AVE STE 1118
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38157-1118
Practice Address - Country:US
Practice Address - Phone:901-683-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004672101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health