Provider Demographics
NPI:1598980823
Name:TOMLINSON, ELIZABETH WAITT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:WAITT
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13456 POINT PLEASANT DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-2453
Mailing Address - Country:US
Mailing Address - Phone:703-378-9320
Mailing Address - Fax:703-378-6775
Practice Address - Street 1:8421 DORSEY CIR STE 102
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4594
Practice Address - Country:US
Practice Address - Phone:705-715-6969
Practice Address - Fax:703-365-2306
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040028441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA333412OtherANTHEM BLUE CROSS BLUE SH