Provider Demographics
NPI:1992975965
Name:BARR, ELIZABETH ANN (LICSW)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:BARR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:SLOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:409 FORTUNE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-1741
Mailing Address - Country:US
Mailing Address - Phone:508-259-9282
Mailing Address - Fax:
Practice Address - Street 1:409 FORTUNE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1741
Practice Address - Country:US
Practice Address - Phone:508-259-9282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114828101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)