Provider Demographics
NPI:1346464500
Name:TESSIER, ELISSA MCCARTHY (MA)
Entity Type:Individual
Prefix:MS
First Name:ELISSA
Middle Name:MCCARTHY
Last Name:TESSIER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:ELISSA
Other - Middle Name:
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:O17 SAINT MARC CIR
Mailing Address - Street 2:BLDG O
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-4150
Mailing Address - Country:US
Mailing Address - Phone:860-966-2928
Mailing Address - Fax:
Practice Address - Street 1:O17 SAINT MARC CIR
Practice Address - Street 2:BLDG O
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-4150
Practice Address - Country:US
Practice Address - Phone:860-966-2928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist