Provider Demographics
NPI:1346202702
Name:ELLIOTT, CATHERINE MICHELE (LMHC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MICHELE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1322
Mailing Address - Country:US
Mailing Address - Phone:978-223-0672
Mailing Address - Fax:781-342-7953
Practice Address - Street 1:607 NORTH AVE
Practice Address - Street 2:DOOR 18
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880
Practice Address - Country:US
Practice Address - Phone:978-223-0672
Practice Address - Fax:781-596-3401
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health