Healthcare Provider Details

I. General information

NPI: 1396423638
Provider Name (Legal Business Name): ELIZABETH ANNE BARR ATWOOD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 STATE RD
MEDIA PA
19063-1574
US

IV. Provider business mailing address

205 RIDGEWOOD RD
MEDIA PA
19063-1723
US

V. Phone/Fax

Practice location:
  • Phone: 610-890-6426
  • Fax:
Mailing address:
  • Phone: 610-890-6426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberPC012462
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-0012079
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC012462
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: