Provider Demographics
NPI:1568525327
Name:SPAULDING, ELIZABETH ANN (LICSW MA 113010)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:LICSW MA 113010
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW MA 113010
Mailing Address - Street 1:650 FERRY STREET
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050
Mailing Address - Country:US
Mailing Address - Phone:781-837-6281
Mailing Address - Fax:
Practice Address - Street 1:650 FERRY STREET
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050
Practice Address - Country:US
Practice Address - Phone:781-837-6281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1130111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical