Provider Demographics
NPI:1720561780
Name:MEYER, ELIZABETH (LICSW, MSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RICKEY DR
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6122
Mailing Address - Country:US
Mailing Address - Phone:508-479-4772
Mailing Address - Fax:
Practice Address - Street 1:54 FRONT ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-1647
Practice Address - Country:US
Practice Address - Phone:508-861-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA118554-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical