Provider Demographics
NPI:1891145272
Name:ELWELL, DESSIE (MA, EDS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:DESSIE
Middle Name:
Last Name:ELWELL
Suffix:
Gender:F
Credentials:MA, EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-1656
Mailing Address - Country:US
Mailing Address - Phone:540-324-3069
Mailing Address - Fax:
Practice Address - Street 1:2015 RESERVOIR ST
Practice Address - Street 2:SUITE 205
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8781
Practice Address - Country:US
Practice Address - Phone:540-324-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006339101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional