Provider Demographics
NPI:1952649998
Name:NOVACEK, ELIZABETH SARAH (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SARAH
Last Name:NOVACEK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:SARAH
Other - Last Name:CULVERHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 ENGAMORE LN
Mailing Address - Street 2:APT 201
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-2429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 ENGAMORE LN
Practice Address - Street 2:APT 201
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2429
Practice Address - Country:US
Practice Address - Phone:774-313-8549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1166611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical