Provider Demographics
NPI:1275056269
Name:DESILETS DE CARDENAS, ELIZABETH (LMHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DESILETS DE CARDENAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:BURROWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:67 FOREST ST STE 264
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3088
Mailing Address - Country:US
Mailing Address - Phone:774-289-3274
Mailing Address - Fax:
Practice Address - Street 1:67 FOREST ST STE 264
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3088
Practice Address - Country:US
Practice Address - Phone:774-289-3274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health