Provider Demographics
NPI:1083352355
Name:SHURTE, ELIZABETH ANNA (LPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNA
Last Name:SHURTE
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 1:8720 FOREST HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2432
Mailing Address - Country:US
Mailing Address - Phone:336-682-5222
Mailing Address - Fax:
Practice Address - Street 1:8720 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-2432
Practice Address - Country:US
Practice Address - Phone:336-682-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010188101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health