Elizabeth Sue Wyman, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701008278 Issued in VA

Practice address

4899 Prince William Pkwy
Woodbridge, VA 22192-5434

Phone

(833) 510-4357

NPI assigned

Jun 3, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Sue Salazar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1003264722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4899 PRINCE WILLIAM PKWY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925434",
            "telephone_number": "833-510-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1360 Beverly Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013647",
            "country_code": "US",
            "telephone_number": "703-831-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "ELIZABETH",
        "middle_name": "SUE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008278",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DE",
            "license": "PC-0011112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SALAZAR",
            "middle_name": "SUE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Richard Wyatt, LPC, CSOTP
• Mary Jane Wyman, M.D.
• Olga Vladimirovna Wymore
• Todd E Wynkoop, DDS
• Alan Howard Wynn, M.D.
• Andrew Ross Wynn, LCSW

• Professional Counselor in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.