Provider Demographics
NPI:1447774567
Name:WESTBROOK, ELIZABETH R (LPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:WESTBROOK
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 1:233 SWEET CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-8142
Mailing Address - Country:US
Mailing Address - Phone:843-693-5112
Mailing Address - Fax:
Practice Address - Street 1:222 W COLEMAN BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3588
Practice Address - Country:US
Practice Address - Phone:843-693-5112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7573101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC435201Medicaid
SC3348OtherMEDICARE PIN