ESSENTIAL LIFE THERAPIES INC NPI 1063592608

NPI Information

  • NPI: 1063592608
  • Provider Name: ESSENTIAL LIFE THERAPIES INC
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Address: 5507 DOWNING ST
    ROANOKE, VA
    ZIP 24018
  • Phone: (540) 989-0315

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NPI Details

ESSENTIAL LIFE THERAPIES INC is a clinical social worker in Roanoke, VA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. ESSENTIAL LIFE THERAPIES INC NPI is 1063592608. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5507 DOWNING ST
ROANOKE, VA
ZIP 24018-704
Phone: (540) 989-0315
Fax: (540) 774-1292

The provider's authorized official is Jackie C Claxton .
The authorized official title is President and has the following contact phone number (540) 989-0315.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 6/23/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1215418OTHERVIRGINIAANTHEM BCBS
2C09303MEDICARE ID-TYPE UNSPECIFIEDVIRGINIA
3008925721MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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