Provider Demographics
NPI:1669257382
Name:HAGERMAN, ELIZABETH (LGPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HAGERMAN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5740
Mailing Address - Country:US
Mailing Address - Phone:301-233-7264
Mailing Address - Fax:
Practice Address - Street 1:5039 CONNECTICUT AVE NW STE 7
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2056
Practice Address - Country:US
Practice Address - Phone:202-660-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00309101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor