Provider Demographics
NPI:1730259847
Name:STERN, ELIZABETH M (LICSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:M
Last Name:STERN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20 CAMBRIDGE TERRACE
Mailing Address - Street 2:APT 1
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140
Mailing Address - Country:US
Mailing Address - Phone:617-354-1945
Mailing Address - Fax:617-492-5989
Practice Address - Street 1:20 CAMBRIDGE TERRACE
Practice Address - Street 2:APT 1
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140
Practice Address - Country:US
Practice Address - Phone:617-354-1945
Practice Address - Fax:617-492-5989
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10301891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical