Provider Demographics
NPI:1851865166
Name:FARASEY, ELIZABETH RAPP (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:RAPP
Last Name:FARASEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25476 CROSSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-3904
Mailing Address - Country:US
Mailing Address - Phone:513-509-7064
Mailing Address - Fax:
Practice Address - Street 1:43130 AMBERWOOD PLZ STE 140
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-4107
Practice Address - Country:US
Practice Address - Phone:513-509-7064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-20
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701008120OtherLPC LICENSE