Healthcare Provider Details

I. General information

NPI: 1023954963
Provider Name (Legal Business Name): ELISE LAMPRECHT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 SANTA ROSA RD RM 211
RICHMOND VA
23229-5105
US

IV. Provider business mailing address

4506 SCOTLOW CIR
NORTH CHESTERFIELD VA
23234-5450
US

V. Phone/Fax

Practice location:
  • Phone: 504-303-9622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020368
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: