Provider Demographics
NPI:1710180179
Name:CALLEN-PRATT, ELIZABETH A (LMHC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:CALLEN-PRATT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9545 COUNTY ROAD 7
Mailing Address - Street 2:COUNTY RD 7
Mailing Address - City:CUBA
Mailing Address - State:NY
Mailing Address - Zip Code:14727-9264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 LEO MOSS DR
Practice Address - Street 2:SUITE 4308
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1100
Practice Address - Country:US
Practice Address - Phone:716-373-8040
Practice Address - Fax:716-373-4820
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000707-1101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor