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General NPI Number Information
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NPI Number | 1194675017
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Entity Type | Organization
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Legal Business Name | LOUIS ELIACIN CONSULTING & CLINICAL SERVICES, PLLC
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 1074 BROWNSTONE LN
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City | FOREST
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State | VA
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Zip | 24551-2492
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Country | US
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Telephone | 434-709-9009
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Fax |
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Provider Business Mailing Address
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Address Line | 1074 BROWNSTONE LN
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City | FOREST
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State | VA
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Zip | 24551-2492
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Country | US
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Telephone | 434-709-9009
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Fax |
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Authorized Official
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Title or Position | LICENSED PROVIDER
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Name | LOUIS EDGARD ELIACIN JR.
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Credential | LPC
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Telephone | 434-709-9009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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