Provider Demographics
NPI:1871704346
Name:DRESSER, ELIZABETH (LGSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DRESSER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 CARMELO DR
Mailing Address - Street 2:#201
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5244
Mailing Address - Country:US
Mailing Address - Phone:703-942-5321
Mailing Address - Fax:
Practice Address - Street 1:3900 FORESTVILLE RD
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:MD
Practice Address - Zip Code:20747-4715
Practice Address - Country:US
Practice Address - Phone:301-736-2636
Practice Address - Fax:301-736-2405
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG11755104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0903001344Medicaid
MDG11755Medicaid
DCLG50077958Medicaid