MEDICARE: ELIZABETH ULIRSCH CONSULTING, LLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1992112338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH ULIRSCH CONSULTING, LLC

Provider Business Mailing Address
First Line	:	4925 BUCKHORN RD
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-8605
Country	:	US
Telephone Number	:	540-685-3284
Fax Number	:

Provider Business Practice Location Address
First Line	:	4925 BUCKHORN RD
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-8605
Country	:	US
Telephone Number	:	540-685-3284
Fax Number	:

Authorized Official
Title or Position	:	COUNSELING THERAPIST
Name	:	MS. ELIZABETH ULIRSCH
Credential	:	MA
Telephone Number	:	540-685-3284

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/17/2014

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