Provider Demographics
NPI:1891826475
Name:MAY, ELIZABETH DIANE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:DIANE
Last Name:MAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LOTTIE ST.
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-647-7764
Mailing Address - Fax:831-647-7940
Practice Address - Street 1:1200 AGUAJITO RD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4887
Practice Address - Country:US
Practice Address - Phone:831-647-7764
Practice Address - Fax:831-647-7940
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 21727101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA368Medicaid
CA368Medicaid
CA368Medicare UPIN