Provider Demographics
NPI:1407101181
Name:SARANTOPOULOS, ELIZABETH M (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:SARANTOPOULOS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 BOSTON POST RD STE 208
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3007
Mailing Address - Country:US
Mailing Address - Phone:508-254-0102
Mailing Address - Fax:
Practice Address - Street 1:322 BOSTON POST RD STE 208
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3007
Practice Address - Country:US
Practice Address - Phone:508-254-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1167281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical