Provider Demographics
NPI:1841606647
Name:RZENGOTA, ELIZABETH JOY (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JOY
Last Name:RZENGOTA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:JOY
Other - Last Name:CLOUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10301 DEMOCRACY LN STE 275
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2525
Mailing Address - Country:US
Mailing Address - Phone:703-397-3124
Mailing Address - Fax:703-539-0004
Practice Address - Street 1:10301 DEMOCRACY LN STE 275
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:845-321-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional