Healthcare Provider Details

I. General information

NPI: 1992538938
Provider Name (Legal Business Name): ELIZABETH JOY GEDDES M.ED., NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 CORNERSTONE ST APT 103
LYNCHBURG VA
24502-5447
US

IV. Provider business mailing address

212 VILLA VIEW PL
LYNCHBURG VA
24502-4493
US

V. Phone/Fax

Practice location:
  • Phone: 864-497-2216
  • Fax:
Mailing address:
  • Phone: 864-497-2216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701013866
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: