Provider Demographics
NPI:1386068252
Name:ELAM-MANNING, VIRGINIA (LPC)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:ELAM-MANNING
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 1:2725 REED RD
Mailing Address - Street 2:1908
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-2371
Mailing Address - Country:US
Mailing Address - Phone:281-904-6483
Mailing Address - Fax:
Practice Address - Street 1:2626 S LOOP W
Practice Address - Street 2:SUITE 650H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2654
Practice Address - Country:US
Practice Address - Phone:281-904-6483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional