Provider Demographics
NPI:1811628423
Name:ELISE M. VANDAMIA, EDD, LPC
Entity Type:Organization
Organization Name:ELISE M. VANDAMIA, EDD, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LIC. PROFESSIONAL COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:MARITA
Authorized Official - Last Name:VANDAMIA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC
Authorized Official - Phone:724-298-8455
Mailing Address - Street 1:807 WINDOVER DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15071-9395
Mailing Address - Country:US
Mailing Address - Phone:724-298-8455
Mailing Address - Fax:
Practice Address - Street 1:807 WINDOVER DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-9395
Practice Address - Country:US
Practice Address - Phone:724-298-8455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELISE M. VANDAMIA, EDD, LPC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty