Provider Demographics
NPI:1316224561
Name:WHITESIDES, ELIZABETH MICHELL (LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MICHELL
Last Name:WHITESIDES
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BLUE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-8724
Mailing Address - Country:US
Mailing Address - Phone:828-707-5414
Mailing Address - Fax:
Practice Address - Street 1:233 S FRENCH BROAD AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-254-0749
Practice Address - Fax:828-254-0762
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-2787101YA0400X
NC9104101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health