Provider Demographics
NPI:1487076626
Name:YOUNG WEEDEN, ELIZABETH (LPC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:YOUNG WEEDEN
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 1:3624 CAMDEN ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1224
Mailing Address - Country:US
Mailing Address - Phone:202-904-3610
Mailing Address - Fax:
Practice Address - Street 1:3624 CAMDEN ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1224
Practice Address - Country:US
Practice Address - Phone:202-904-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC13963101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional