Provider Demographics
NPI:1831991082
Name:ELAM, TERESE (LCSW)
Entity type:Individual
Prefix:
First Name:TERESE
Middle Name:
Last Name:ELAM
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8167 PEANUT DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VA
Mailing Address - Zip Code:23487-8218
Mailing Address - Country:US
Mailing Address - Phone:757-687-9832
Mailing Address - Fax:757-687-9832
Practice Address - Street 1:8167 PEANUT DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:VA
Practice Address - Zip Code:23487-8218
Practice Address - Country:US
Practice Address - Phone:757-687-9832
Practice Address - Fax:757-687-9832
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040179491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical