Provider Demographics
NPI:1548601297
Name:BECK, ELSA ILEANA (LPC)
Entity type:Individual
Prefix:
First Name:ELSA
Middle Name:ILEANA
Last Name:BECK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 CUNNINGHAM DR
Mailing Address - Street 2:400
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3375
Mailing Address - Country:US
Mailing Address - Phone:757-838-1960
Mailing Address - Fax:757-838-3280
Practice Address - Street 1:341 MCLAWS CIRCLE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:757-229-8081
Practice Address - Fax:757-229-4970
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005449101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional