Provider Demographics
NPI:1578141891
Name:ESPOSITO, ELIZABETH ANYCE (LGSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANYCE
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 N KANAWHA ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2767
Mailing Address - Country:US
Mailing Address - Phone:304-472-1500
Mailing Address - Fax:
Practice Address - Street 1:29 S KANAWHA ST
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2625
Practice Address - Country:US
Practice Address - Phone:304-473-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00945877104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker