Provider Demographics
NPI:1154829745
Name:HARE, ELIZABETH (MED, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:HARE
Suffix:
Gender:F
Credentials:MED, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1121
Mailing Address - Country:US
Mailing Address - Phone:413-626-7905
Mailing Address - Fax:
Practice Address - Street 1:UMASS AMHERST
Practice Address - Street 2:CCPH, BARTLLETT HALL, 130 HICKS WAY
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003
Practice Address - Country:US
Practice Address - Phone:413-545-2337
Practice Address - Fax:413-545-2337
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2216091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical