Provider Demographics
NPI:1073616991
Name:HAAS, ELIZABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HAAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77B WARREN STREET
Mailing Address - Street 2:C/O BRIGHTON ALLSTON MENTAL HEALTH
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3601
Mailing Address - Country:US
Mailing Address - Phone:617-787-1901
Mailing Address - Fax:617-254-3461
Practice Address - Street 1:77B WARREN STREET
Practice Address - Street 2:C/O BRIGHTON ALLSTON MENTAL HEALTH
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3601
Practice Address - Country:US
Practice Address - Phone:617-787-1901
Practice Address - Fax:617-254-3461
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical