Provider Demographics
NPI:1578034286
Name:WILSON, ELIZABETH (LPC-A, CSAC-I)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:LPC-A, CSAC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 ROSE HILL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8544
Mailing Address - Country:US
Mailing Address - Phone:919-884-5686
Mailing Address - Fax:
Practice Address - Street 1:30 GARFIELD ST STE A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-7301
Practice Address - Country:US
Practice Address - Phone:828-254-3483
Practice Address - Fax:828-254-3485
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14453101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA14453OtherNORTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORS