Provider Demographics
NPI:1164570677
Name:DREW, ELIZABETH DARLENE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DARLENE
Last Name:DREW
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 1:1401 MARINES DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-0919
Mailing Address - Country:US
Mailing Address - Phone:972-832-9199
Mailing Address - Fax:
Practice Address - Street 1:4645 AVON LN
Practice Address - Street 2:STE 190B
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1549
Practice Address - Country:US
Practice Address - Phone:972-259-0109
Practice Address - Fax:469-777-3812
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16667101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168624801Medicaid