Provider Demographics
NPI:1295076420
Name:VARNEY, ELIZABETH ORMOND (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ORMOND
Last Name:VARNEY
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 1:324 W BLAKE ST
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-2419
Mailing Address - Country:US
Mailing Address - Phone:530-227-5193
Mailing Address - Fax:
Practice Address - Street 1:324 W BLAKE ST
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-2419
Practice Address - Country:US
Practice Address - Phone:530-227-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11775OtherLICENSED CLINICAL SOCIAL WORKER