Individual
JESSICA BONEA ELIACIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1240 3RD ST SW, ROANOKE, VA 24016-4612
(540) 344-5156
(540) 342-0220
Mailing address
3522 SUNCHASE LN APT 903, ROANOKE, VA 24018-3192
(434) 250-3916
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704011037
VA
101YP2500X
Professional Counselor
Primary
0704011037
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0704011037
—
VA
Enumeration date
03/24/2022
Last updated
02/23/2026
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