Healthcare Provider Details

I. General information

NPI: 1356265185
Provider Name (Legal Business Name): MS. ELIZABETH TRIBBLE LEMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1553 BRADFORD RD STE 102
VIRGINIA BEACH VA
23455-4094
US

IV. Provider business mailing address

2437 LEYTONSTONE DR
CHESAPEAKE VA
23321-2467
US

V. Phone/Fax

Practice location:
  • Phone: 757-453-2144
  • Fax:
Mailing address:
  • Phone: 757-453-2144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020766
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: