Provider Demographics
NPI:1023798303
Name:LORANGER, ELEASE NICHELLE
Entity type:Individual
Prefix:
First Name:ELEASE
Middle Name:NICHELLE
Last Name:LORANGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 NELSON DR APT 8
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-3432
Mailing Address - Country:US
Mailing Address - Phone:804-239-0752
Mailing Address - Fax:
Practice Address - Street 1:491 NELSON DR APT 8
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3432
Practice Address - Country:US
Practice Address - Phone:804-239-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0730000704106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist