Provider Demographics
NPI:1699331629
Name:WOFFORD, ELIZABETH J (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:J
Last Name:WOFFORD
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 SHIPLEY ST APT 1021
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-4162
Mailing Address - Country:US
Mailing Address - Phone:979-595-6345
Mailing Address - Fax:
Practice Address - Street 1:952 HOUSTON NORTHCUTT BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5659
Practice Address - Country:US
Practice Address - Phone:732-223-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7140101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNONE