Provider Demographics
NPI:1356105449
Name:SCHUBERT, ELIZABETH ELLIS (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ELLIS
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12156 FOX MILL RUN LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-3056
Mailing Address - Country:US
Mailing Address - Phone:804-512-4968
Mailing Address - Fax:
Practice Address - Street 1:12156 FOX MILL RUN LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-3056
Practice Address - Country:US
Practice Address - Phone:804-512-4968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003027101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional