Individual
MR. GEORGE HENRY ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
132 W ELWOOD AVE, RAEFORD, NC 28376-2802
(910) 875-0070
(910) 875-0072
Mailing address
9530 MOUNTAIN HOME DR, FAYETTEVILLE, NC 28314-5761
(910) 826-6795
(910) 875-0072
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4122
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140P9
BLUECROSS BLUESHIELD LPC
NC
05
—
6102023
—
NC
Enumeration date
08/09/2006
Last updated
07/09/2007
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