Provider Demographics
NPI:1669652285
Name:HARRISON, ELIZABETH CLAIRE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:HARRISON
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 1:311 W EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-2655
Mailing Address - Country:US
Mailing Address - Phone:781-718-7571
Mailing Address - Fax:
Practice Address - Street 1:311 W EMERSON ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-2655
Practice Address - Country:US
Practice Address - Phone:781-718-7571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1079081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical