Provider Demographics
NPI:1851471668
Name:WESCOAT, ELAINE KAY (LPC, LSATP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:KAY
Last Name:WESCOAT
Suffix:
Gender:F
Credentials:LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 LAFAYETTE BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4271
Mailing Address - Country:US
Mailing Address - Phone:540-847-2876
Mailing Address - Fax:540-371-4333
Practice Address - Street 1:4414 LAFAYETTE BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4271
Practice Address - Country:US
Practice Address - Phone:540-847-2876
Practice Address - Fax:540-371-4333
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000093101YA0400X
VA0701003515101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA134304882OtherTAX IDENTIFICATION NUMBER