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General NPI Number Information
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NPI Number | 1649789983
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Entity Type | Organization
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Legal Business Name | ELIZABETH MCGINNIS LPC LMFT LLC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 640 INDEPENDENCE PKWY STE 100
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City | CHESAPEAKE
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State | VA
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Zip | 23320-5205
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Country | US
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Telephone | 757-420-0530
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Fax |
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Provider Business Mailing Address
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Address Line | 1126 CRYSTALWOOD CIR
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City | CHESAPEAKE
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State | VA
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Zip | 23320-5118
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Country | US
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Telephone | 757-435-6296
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MRS. ELIZABETH MCGINNIS
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Credential | LPC LMFT
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Telephone | 757-435-6296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717000593
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701002145
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License Number State | VA
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