Provider Demographics
NPI:1063707909
Name:WHEELER, ELISABETH J (LMHC)
Entity type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:J
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:ELISABETH
Other - Middle Name:J
Other - Last Name:DANISH-WHEELER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262-0696
Mailing Address - Country:US
Mailing Address - Phone:413-298-5368
Mailing Address - Fax:413-298-5368
Practice Address - Street 1:3 HILL RD.
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262
Practice Address - Country:US
Practice Address - Phone:413-298-5368
Practice Address - Fax:413-298-5368
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5802101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health