Provider Demographics
NPI:1144827130
Name:HUSSEY, ELIZABETH ANNE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:HUSSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 S WALTER REED DR UNIT D
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1208
Mailing Address - Country:US
Mailing Address - Phone:703-380-2542
Mailing Address - Fax:
Practice Address - Street 1:2507 S WALTER REED DR UNIT D
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-1208
Practice Address - Country:US
Practice Address - Phone:703-380-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-03
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704009632101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health