Provider Demographics
NPI:1740636158
Name:PAPA, ELIZABETH LEANE (MED, EDS LPC LMHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEANE
Last Name:PAPA
Suffix:
Gender:F
Credentials:MED, EDS LPC LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10335 GULF BEACH HWY UNIT 1203
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-2178
Mailing Address - Country:US
Mailing Address - Phone:662-801-3113
Mailing Address - Fax:
Practice Address - Street 1:10335 GULF BEACH HWY UNIT 1203
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-2178
Practice Address - Country:US
Practice Address - Phone:662-801-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006635101YM0800X
CALPCC2781174400000X
FLMH16993101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174400000XOther Service ProvidersSpecialist