Provider Demographics
NPI:1124389622
Name:FIELD, ELIZABETH H (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:H
Last Name:FIELD
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 1:53 WEYBRIDGE ST
Mailing Address - Street 2:APT D
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1090
Mailing Address - Country:US
Mailing Address - Phone:802-282-2246
Mailing Address - Fax:
Practice Address - Street 1:53 WEYBRIDGE ST
Practice Address - Street 2:APT D
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1090
Practice Address - Country:US
Practice Address - Phone:802-282-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900737281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical