Provider Demographics
NPI:1558709824
Name:BERTUZZI, ELYZA TOLEDO (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ELYZA
Middle Name:TOLEDO
Last Name:BERTUZZI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:ELYZA
Other - Middle Name:
Other - Last Name:TOLEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:545 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-4727
Mailing Address - Country:US
Mailing Address - Phone:978-345-0685
Mailing Address - Fax:978-342-8495
Practice Address - Street 1:354 WAVERLEY ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7079
Practice Address - Country:US
Practice Address - Phone:508-661-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health