Provider Demographics
NPI:1174981161
Name:ELSEY, HEATHER (MS,BCBA,LBA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ELSEY
Suffix:
Gender:F
Credentials:MS,BCBA,LBA
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS
Mailing Address - Street 1:802 NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-5519
Mailing Address - Country:US
Mailing Address - Phone:540-336-7016
Mailing Address - Fax:
Practice Address - Street 1:802 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5519
Practice Address - Country:US
Practice Address - Phone:540-336-7016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000641103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst