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NPI Code Detail

MEDICARE: DONNA ELLIOT CSAC

MEDICARE:   DONNA  ELLIOT  CSAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor0710102368VA

General Provider Information

NPI Number : 1316322878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA ELLIOT CSAC
Provider Business Mailing Address
First Line : 5735 E HASTINGS ARCH
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-1506
Country : US
Telephone Number : 757-779-4493
Fax Number :
Provider Business Practice Location Address
First Line : 4100 VA BEACH BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-1744
Country : US
Telephone Number : 757-779-4493
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2015
Last Update Date : 07/27/2015

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Directions to “ DONNA ELLIOT CSAC” Practice Location

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