Provider Demographics
NPI:1568663938
Name:ALLISON, ELIZABETH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:ALLISON
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 1:555 SUN VALLEY DR
Mailing Address - Street 2:BLDG F - SUITE 1A
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5612
Mailing Address - Country:US
Mailing Address - Phone:770-998-0989
Mailing Address - Fax:770-998-1315
Practice Address - Street 1:555 SUN VALLEY DR
Practice Address - Street 2:BLDG F - SUITE 1A
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5612
Practice Address - Country:US
Practice Address - Phone:770-998-0989
Practice Address - Fax:770-998-1315
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003991101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional