Provider Demographics
NPI:1770091530
Name:COMPTON, ANNAMARIE ELMORE (LPC)
Entity type:Individual
Prefix:
First Name:ANNAMARIE
Middle Name:ELMORE
Last Name:COMPTON
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 1:1104 E LAWN DR APT 306
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2990
Mailing Address - Country:US
Mailing Address - Phone:804-898-0687
Mailing Address - Fax:
Practice Address - Street 1:1617 ENTERPRISE DR # A
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5797
Practice Address - Country:US
Practice Address - Phone:804-898-0687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health