Provider Demographics
NPI:1699789453
Name:MURDOCK, ELIZABETH ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MURDOCK
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 1:3300 PACIFIC AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2900
Mailing Address - Country:US
Mailing Address - Phone:804-402-0454
Mailing Address - Fax:
Practice Address - Street 1:3300 PACIFIC AVE APT 202
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2900
Practice Address - Country:US
Practice Address - Phone:804-402-0454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003149101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA208327OtherANTHEM BLUE CROSS BLUE SH
VA010299403Medicaid
VA279778OtherCOMPSYCH
VA010299403OtherVIRGINIA PREMIER HEALTH
VAO802540MOtherSENTARA-OPTIMA