Provider Demographics
NPI:1336906437
Name:SERENS, ELIZABETH HARTMAN (LPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HARTMAN
Last Name:SERENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JEAN
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RESIDENT
Mailing Address - Street 1:3441 BRANDON AVE SW STE 100
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1516
Mailing Address - Country:US
Mailing Address - Phone:540-981-5330
Mailing Address - Fax:540-759-7867
Practice Address - Street 1:3441 BRANDON AVE SW STE 100
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1516
Practice Address - Country:US
Practice Address - Phone:540-981-5330
Practice Address - Fax:540-759-7867
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013288101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional