Provider Demographics
NPI:1366567786
Name:ELSEY, DON EDWORD (EDD LPC)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:EDWORD
Last Name:ELSEY
Suffix:
Gender:M
Credentials:EDD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 KING STREET
Mailing Address - Street 2:DEE NORTH LOW COUNTRY CHILDRENS CENTER
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-3708
Mailing Address - Country:US
Mailing Address - Phone:843-723-3600
Mailing Address - Fax:843-720-7106
Practice Address - Street 1:1061 KING STREET
Practice Address - Street 2:DEE NORTH LOW COUNTRY CHILDRENS CENTER
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-3708
Practice Address - Country:US
Practice Address - Phone:843-723-3600
Practice Address - Fax:843-720-7106
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1770CPC101Y00000X
SC4557 CPC SUPERVISOR101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor