Basic Information
| Provider Information | |||||||||
| NPI: | 1699951228 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RASKAUSKAS | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | LGSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 840 GLEN DR | ||||||||
| Address2: | |||||||||
| City: | BETHANY BEACH | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199309124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025372882 | ||||||||
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| Practice Location | |||||||||
| Address1: | BERLIN HEALTH CENTER | ||||||||
| Address2: | 9730 HEALTHWAY DRIVE | ||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106290164 | ||||||||
| FaxNumber: | 4106290185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2008 | ||||||||
| LastUpdateDate: | 01/14/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | G12415 | MD | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.