Provider Demographics
NPI:1376996314
Name:QUESENBERRY, ELIZABETH YOUNG (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:YOUNG
Last Name:QUESENBERRY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6745 OLD WATERLOO RD APT 224
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-7121
Mailing Address - Country:US
Mailing Address - Phone:804-363-0153
Mailing Address - Fax:
Practice Address - Street 1:815 RITCHIE HWY STE 108
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4192
Practice Address - Country:US
Practice Address - Phone:804-363-0153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker