Provider Demographics
NPI:1164667986
Name:GACS, ELANA LISA (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELANA
Middle Name:LISA
Last Name:GACS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:LISA
Other - Last Name:ZINGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:572 WASHINGTON ST
Mailing Address - Street 2:SUITE #14
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-6418
Mailing Address - Country:US
Mailing Address - Phone:617-686-6716
Mailing Address - Fax:
Practice Address - Street 1:572 WASHINGTON ST
Practice Address - Street 2:SUITE #14
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-6418
Practice Address - Country:US
Practice Address - Phone:617-686-6716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1162921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical