Provider Demographics
NPI:1376554097
Name:DEAN-DIAMOND, ELIZABETH (PSYD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:DEAN-DIAMOND
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:DEAN-DIAMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:873 TURNPIKE STREET
Mailing Address - Street 2:THE SOMERS TRUST
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6105
Mailing Address - Country:US
Mailing Address - Phone:978-688-8004
Mailing Address - Fax:978-686-8554
Practice Address - Street 1:873 TURNPIKE STREET
Practice Address - Street 2:THE SOMERS TRUST
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6105
Practice Address - Country:US
Practice Address - Phone:978-688-8004
Practice Address - Fax:978-686-8554
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31704OtherHEALTH NEW ENGLAND