Basic Information
Provider Information
NPI: 1720529456
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAVETTIERE
FirstName: ELIZABETH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 41 DOLSON AVE
Address2:  
City: MIDDLETOWN
State: NY
PostalCode: 109406489
CountryCode: US
TelephoneNumber: 8453425789
FaxNumber: 8452316078
Practice Location
Address1: 41 DOLSON AVE
Address2:  
City: MIDDLETOWN
State: NY
PostalCode: 109406489
CountryCode: US
TelephoneNumber: 8453425789
FaxNumber: 8452316078
Other Information
ProviderEnumerationDate: 03/14/2017
LastUpdateDate: 03/14/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X007769NYY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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