Provider Demographics
NPI:1316218068
Name:SLATTERY, ELIZABETH SARAH (LCMHC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:SARAH
Last Name:SLATTERY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 948
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03061-0948
Mailing Address - Country:US
Mailing Address - Phone:603-930-9667
Mailing Address - Fax:
Practice Address - Street 1:38 REVERE ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4950
Practice Address - Country:US
Practice Address - Phone:603-930-9667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH901101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health