Provider Demographics
NPI:1174328058
Name:SPINOSA, ELIZABETH (LIZ) ROSE
Entity type:Individual
Prefix:
First Name:ELIZABETH (LIZ)
Middle Name:ROSE
Last Name:SPINOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 ROLLING ACRES RD
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-1550
Mailing Address - Country:US
Mailing Address - Phone:617-733-9809
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:143 ROLLING ACRES RD
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-1550
Practice Address - Country:US
Practice Address - Phone:617-733-9809
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5748101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health