Individual
MS. ELIZABETH CRAWFORD GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
720 N SAINT ASAPH ST, ALEXANDRIA, VA 22314-1912
(703) 838-4455
(703) 838-5070
Mailing address
1933 BYRD RD, VIENNA, VA 22182-3704
(703) 838-4455
(703) 838-5070
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005223
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188796
ANTHEM
VA
01
—
270291
AMERIGROUP VIRGINIA INC.
VA
Enumeration date
12/18/2006
Last updated
07/08/2007
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