Provider Demographics
NPI:1336630391
Name:MASEK, ELIZABETH MARIE (LICSW MBA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:MASEK
Suffix:
Gender:F
Credentials:LICSW MBA
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:MASEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW, MBA
Mailing Address - Street 1:6 SHEFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3028
Mailing Address - Country:US
Mailing Address - Phone:603-305-9013
Mailing Address - Fax:
Practice Address - Street 1:6 SHEFFIELD RD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3028
Practice Address - Country:US
Practice Address - Phone:603-305-9013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19431041C0700X
19431041C0700X
MA1215011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical