Provider Demographics
NPI:1720552581
Name:BROWN, ELIZABETH NEIBAUER (LPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NEIBAUER
Last Name:BROWN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4031 UNIVERSITY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3400
Mailing Address - Country:US
Mailing Address - Phone:571-344-2389
Mailing Address - Fax:
Practice Address - Street 1:4031 UNIVERSITY DR STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3400
Practice Address - Country:US
Practice Address - Phone:571-344-2389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health