Provider Demographics
NPI:1538442108
Name:TOWER, ELIZABETH J (LCSW-R)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:TOWER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4363 MAPLETON RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-9652
Mailing Address - Country:US
Mailing Address - Phone:716-210-2225
Mailing Address - Fax:
Practice Address - Street 1:4363 MAPLETON RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-9652
Practice Address - Country:US
Practice Address - Phone:716-210-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069344-R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical