Provider Demographics
NPI:1841778149
Name:ELMAN, GREGORY B (MS, LPC, CSAC)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:B
Last Name:ELMAN
Suffix:
Gender:M
Credentials:MS, LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 OAKHAM CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-7261
Mailing Address - Country:US
Mailing Address - Phone:757-414-9474
Mailing Address - Fax:
Practice Address - Street 1:7300 OAKHAM CT
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-7261
Practice Address - Country:US
Practice Address - Phone:757-414-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710103122101YA0400X
VA0701007688101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)