Provider Demographics
NPI:1619297249
Name:GUTTENPLAN, ELIZABETH I (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:I
Last Name:GUTTENPLAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:IARRAPINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:72 E DEDHAM ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2315
Mailing Address - Country:US
Mailing Address - Phone:617-292-9920
Mailing Address - Fax:617-292-9274
Practice Address - Street 1:72 E DEDHAM ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2315
Practice Address - Country:US
Practice Address - Phone:617-292-9200
Practice Address - Fax:617-292-9274
Is Sole Proprietor?:No
Enumeration Date:2010-06-05
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1155971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical