Provider Demographics
NPI:1942634977
Name:SNOW, ELIZABETH NICOLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:NICOLE
Last Name:SNOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 SIMPSON LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2117
Mailing Address - Country:US
Mailing Address - Phone:703-431-8484
Mailing Address - Fax:
Practice Address - Street 1:6325 N CENTER DR STE 202
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-0019
Practice Address - Country:US
Practice Address - Phone:757-227-3636
Practice Address - Fax:757-227-3642
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710103198101YA0400X
VA09040112051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)