Provider Demographics
NPI:1841382512
Name:TENER, ELIZABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:TENER
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 1:27 CONGRESS STREET
Mailing Address - Street 2:SUITE 205-7
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7309
Mailing Address - Country:US
Mailing Address - Phone:978-910-0182
Mailing Address - Fax:
Practice Address - Street 1:30 CHURCH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3714
Practice Address - Country:US
Practice Address - Phone:978-741-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1109971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22888Medicare PIN