Provider Demographics
NPI:1578298824
Name:ANDERSON, ELIZABETH BAGWELL (DSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:BAGWELL
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 FOXCROFT DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-9516
Mailing Address - Country:US
Mailing Address - Phone:182-823-0695
Mailing Address - Fax:
Practice Address - Street 1:1238 HENDERSONVILLE RD STE 104
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2730
Practice Address - Country:US
Practice Address - Phone:828-230-6951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO49121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical