Provider Demographics
NPI:1255090874
Name:WOODRUFF, ELIZABETH MARIE (LPC ASSOCIATE)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:MARIE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8435 CEDAR MDWS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6285
Mailing Address - Country:US
Mailing Address - Phone:432-517-5185
Mailing Address - Fax:
Practice Address - Street 1:11901 TOEPPERWEIN RD
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3161
Practice Address - Country:US
Practice Address - Phone:210-951-3479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87567101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional