Provider Demographics
NPI:1992834980
Name:LAWRENCE, ELIZABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:38 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-5009
Mailing Address - Country:US
Mailing Address - Phone:617-484-3113
Mailing Address - Fax:
Practice Address - Street 1:38 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-5009
Practice Address - Country:US
Practice Address - Phone:617-484-3113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1058621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical