Provider Demographics
NPI:1437114980
Name:STOREY, ELIZABETH LINEBARGER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LINEBARGER
Last Name:STOREY
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 1:3366 CYPRESS LAKE DR S
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6864
Mailing Address - Country:US
Mailing Address - Phone:901-413-6853
Mailing Address - Fax:
Practice Address - Street 1:6880 COBBLESTONE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-9313
Practice Address - Country:US
Practice Address - Phone:662-253-8324
Practice Address - Fax:662-253-8336
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional