Provider Demographics
NPI:1144976838
Name:MANSEL, ELIZABETH MCSHERRY
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MCSHERRY
Last Name:MANSEL
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 1:705 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-3407
Mailing Address - Country:US
Mailing Address - Phone:540-529-9062
Mailing Address - Fax:
Practice Address - Street 1:705 GROVE ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-3407
Practice Address - Country:US
Practice Address - Phone:540-529-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPGP0656045101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor