Provider Demographics
NPI:1205190261
Name:PIERCE, ELIZABETH MARIE (MHC)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HOLLAND CT
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-3619
Mailing Address - Country:US
Mailing Address - Phone:518-858-9244
Mailing Address - Fax:
Practice Address - Street 1:135 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2912
Practice Address - Country:US
Practice Address - Phone:518-691-0732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health