Provider Demographics
NPI:1861647612
Name:ELAINE WALTERS MCFERRON
Entity Type:Organization
Organization Name:ELAINE WALTERS MCFERRON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:WALTERS
Authorized Official - Last Name:MCFERRON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:757-486-6515
Mailing Address - Street 1:3419 VIRGINIA BEACH BLVD
Mailing Address - Street 2:B12
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452
Mailing Address - Country:US
Mailing Address - Phone:757-486-6515
Mailing Address - Fax:
Practice Address - Street 1:613 NORTH LYNNHAVEN ROAD
Practice Address - Street 2:B
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452
Practice Address - Country:US
Practice Address - Phone:757-486-6515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000857251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health