Provider Demographics
NPI:1760599179
Name:CRAWFORD, ELISE WADE (LPC)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:WADE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:WADE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8801 SUDLEY RD
Mailing Address - Street 2:SUITE 3211
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20108
Mailing Address - Country:US
Mailing Address - Phone:703-831-6827
Mailing Address - Fax:
Practice Address - Street 1:8801 SUDLEY RD
Practice Address - Street 2:SUITE 3211
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20108
Practice Address - Country:US
Practice Address - Phone:703-831-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003933101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional