Provider Demographics
NPI:1013043892
Name:SPEAR, ELIZABETH JANE (LMHC, LMFT,)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:SPEAR
Suffix:
Gender:F
Credentials:LMHC, LMFT,
Other - Prefix:
Other - First Name:BETTE
Other - Middle Name:JANE
Other - Last Name:SPEAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC, LMFT
Mailing Address - Street 1:259 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8406
Mailing Address - Country:US
Mailing Address - Phone:617-816-6402
Mailing Address - Fax:
Practice Address - Street 1:259 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8406
Practice Address - Country:US
Practice Address - Phone:617-816-6402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1627101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1627OtherLICENSED MENTAL HEALTH CO
MA911OtherMARRIAGE & FAMILY THERAPI