Provider Demographics
NPI:1568520419
Name:MARTEL, ELIZABETH P (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:P
Last Name:MARTEL
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 1:89 KARL CIR
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:VT
Mailing Address - Zip Code:05602-9526
Mailing Address - Country:US
Mailing Address - Phone:802-223-7364
Mailing Address - Fax:802-223-8679
Practice Address - Street 1:146 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2920
Practice Address - Country:US
Practice Address - Phone:802-229-2800
Practice Address - Fax:802-223-9150
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900008451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical