Provider Demographics
NPI:1184902769
Name:FAUGHN, ELIZABETH H (MSW, LCSW, MDIV)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:H
Last Name:FAUGHN
Suffix:
Gender:F
Credentials:MSW, LCSW, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 WARES GAP RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:VA
Mailing Address - Zip Code:24574-2580
Mailing Address - Country:US
Mailing Address - Phone:434-946-5331
Mailing Address - Fax:
Practice Address - Street 1:1551 WARES GAP RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:VA
Practice Address - Zip Code:24574-2580
Practice Address - Country:US
Practice Address - Phone:434-610-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0025031041C0700X
VA09040072551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical