Provider Demographics
NPI:1134395262
Name:BOSMAJIAN, ELIZABETH ANN (PSYD,LPC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:BOSMAJIAN
Suffix:
Gender:F
Credentials:PSYD,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 HARRISON ST SE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3720
Mailing Address - Country:US
Mailing Address - Phone:703-669-2953
Mailing Address - Fax:703-669-2953
Practice Address - Street 1:333 HARRISON ST SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3720
Practice Address - Country:US
Practice Address - Phone:703-669-2953
Practice Address - Fax:703-669-2953
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1226101YA0400X
VA0701003154101YM0800X, 101YP2500X
MDLC 0898101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health