Provider Demographics
NPI:1124105770
Name:BARRAGATO, ELIZABETH (LMHC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:BARRAGATO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3212
Mailing Address - Country:US
Mailing Address - Phone:617-721-7560
Mailing Address - Fax:617-876-0731
Practice Address - Street 1:14 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3212
Practice Address - Country:US
Practice Address - Phone:617-721-7560
Practice Address - Fax:617-876-0731
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4783101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM0993OtherBLUE CROSS BLUE SHIELD #