Provider Demographics
NPI:1306527510
Name:DRAKE, ELIZABETH BRIANNA (LPCA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BRIANNA
Last Name:DRAKE
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 TEA OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-6935
Mailing Address - Country:US
Mailing Address - Phone:706-936-6311
Mailing Address - Fax:
Practice Address - Street 1:801 GERVAIS ST STE 2B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3125
Practice Address - Country:US
Practice Address - Phone:706-936-6311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health