Provider Demographics
NPI:1891833364
Name:GEISEL, ELIZABETH K (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:K
Last Name:GEISEL
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:120 RIVERWAY
Mailing Address - Street 2:APT 8
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4125
Mailing Address - Country:US
Mailing Address - Phone:617-457-8140
Mailing Address - Fax:617-457-8141
Practice Address - Street 1:130 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-4608
Practice Address - Country:US
Practice Address - Phone:617-457-8140
Practice Address - Fax:617-457-8141
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2139751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical