Provider Demographics
NPI:1811240617
Name:BURDICK, ELISSA DEANNE (MA, NBC-HWC)
Entity type:Individual
Prefix:
First Name:ELISSA
Middle Name:DEANNE
Last Name:BURDICK
Suffix:
Gender:F
Credentials:MA, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SANDERSON ST FL 1
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2712
Mailing Address - Country:US
Mailing Address - Phone:413-336-5894
Mailing Address - Fax:
Practice Address - Street 1:8 SANDERSON ST FL 1
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2712
Practice Address - Country:US
Practice Address - Phone:413-336-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health