Provider Demographics
NPI:1285398966
Name:ALLEN, EMILEIGH E (LRIC)
Entity type:Individual
Prefix:MRS
First Name:EMILEIGH
Middle Name:E
Last Name:ALLEN
Suffix:
Gender:
Credentials:LRIC
Other - Prefix:MS
Other - First Name:EMILEIGH
Other - Middle Name:E
Other - Last Name:EARLENBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LRIC
Mailing Address - Street 1:505 S INDEPENDENCE BLVD STE 213
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1150
Mailing Address - Country:US
Mailing Address - Phone:757-376-8167
Mailing Address - Fax:757-452-4447
Practice Address - Street 1:505 S INDEPENDENCE BLVD STE 213
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1150
Practice Address - Country:US
Practice Address - Phone:757-376-8167
Practice Address - Fax:757-452-4447
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014699101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional