Basic Information
Provider Information
NPI: 1467439562
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNTOON
FirstName: ELIZABETH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 37 FRIEND STREET
Address2: ELEMENT CARE INC
City: LYNN
State: MA
PostalCode: 01902
CountryCode: US
TelephoneNumber: 7817156608
FaxNumber: 7817156699
Practice Location
Address1: 20 SCHOOL STREET
Address2:  
City: LYNN
State: MA
PostalCode: 01902
CountryCode: US
TelephoneNumber: 6172881140
FaxNumber: 6172883910
Other Information
ProviderEnumerationDate: 12/29/2005
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X101388MAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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