Provider Demographics
NPI:1215644323
Name:SAVAGE, ELIZABETH (LICSW, CMC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:LICSW, CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 PRENTISS ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:N CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2242
Mailing Address - Country:US
Mailing Address - Phone:617-599-2061
Mailing Address - Fax:
Practice Address - Street 1:180 WELLS AVE STE 101
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3328
Practice Address - Country:US
Practice Address - Phone:617-928-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1223901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical