Provider Demographics
NPI:1679906150
Name:SCARBOROUGH, ELIZABETH MOZELLE DOZIER (LPC, ATR-BC, CTS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MOZELLE DOZIER
Last Name:SCARBOROUGH
Suffix:
Gender:F
Credentials:LPC, ATR-BC, CTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 BICKLEY RD
Mailing Address - Street 2:APT. 2
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4527
Mailing Address - Country:US
Mailing Address - Phone:610-733-0246
Mailing Address - Fax:
Practice Address - Street 1:162 BICKLEY RD
Practice Address - Street 2:APT. 2
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4527
Practice Address - Country:US
Practice Address - Phone:610-733-0246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health