Elaine Julia Beaudoin, LICSW,LADC
Individual provider Active NPI Clinical Social Worker · Easthampton, MA
NPI 1205936846 · NPPES record last updated Apr 13, 2012
Key facts
- NPI
- 1205936846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 114345 (MA)
- Practice address
- 238 Northampton St
Easthampton, MA 01027-1046 - Phone
- (413) 529-9300
- Fax
- (413) 282-3880
- NPI assigned
- Sep 24, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114345 | MA | MD | Clinical Social Worker |
| 002251 | CT | MD | Occupational Therapist |
| 2208 | MA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 114345 | MA | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2208 | MA |
Addresses
Primary practice location
238 Northampton St
Easthampton, MA 01027-1046
Mailing address
PO Box 5700
Belfast, ME 04915-5700
Phone (866) 431-4077
Other providers in Easthampton, MA
- Kristopher Darrell Banks
- Ashley Rose Barnes
- Lisa Barondes
- Trisha A Barrett
- Jennifer L. Beal
- Edouard Olivier Beauvais Jr.
- Kirsten Marie Beck
- Nicole Bedard
- Lynnette J Bednaz
- Michael Belitsky
All providers in Easthampton, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.