Provider Demographics
NPI:1396794376
Name:KEMP, ELIZABETH A (PHD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:KEMP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SANGERS LN
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-6712
Mailing Address - Country:US
Mailing Address - Phone:540-887-3200
Mailing Address - Fax:540-887-3258
Practice Address - Street 1:3504 VANN ROAD
Practice Address - Street 2:STE 100, GRAYSON & ASSOCIATES PC
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235
Practice Address - Country:US
Practice Address - Phone:205-655-0585
Practice Address - Fax:205-655-0586
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL890006820Medicaid
AL051098178OtherBCBS OF AL
AL890006820Medicaid
AL000055996Medicare ID - Type Unspecified