Individual
KIMBERLY JO ELIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
406 CHATHAM SQUARE OFFICE PARK, SUITE 102, FREDERICKSBURG, VA 22405-2585
(907) 831-1243
(540) 373-6266
Mailing address
1301 DUNES ST, APT 101, FREDERICKSBURG, VA 22401-5027
(907) 831-1243
(540) 373-6266
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000230
VA
101YP2500X
Professional Counselor
Primary
0701004471
VA
Other
Enumeration date
07/08/2010
Last updated
03/28/2015
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