Active NPI
Elizabeth Surprenant, LICSW
- Clinical Social Worker
- Lawrence, MA
National Provider Identifier
1710390992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 120235
- Practice address
- 187 Mount Vernon Street
Apt. 2E
Lawrence, MA 01843 - Phone
- (978) 225-3249
- Fax
- (844) 432-5011
- NPI assigned
- Jun 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 2576 | NH | |
| Clinical Social Worker | 1041C0700X | 120235 | MA | Primary |
Addresses
Primary practice location
187 Mount Vernon Street
Apt. 2E
Lawrence, MA 01843
Mailing address
187 Mount Vernon Street
Apt. 2E
Lawrence, MA 01843
Phone (978) 225-3249
Other names 1
- Elizabeth D'Onofrio
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120235 | MA | MD | Clinical Social Worker |
| 2576 | NH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Justice Resource Institute, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Acton, MA
- NPI 1295909760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1710390992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 MOUNT VERNON STREET",
"address_2": "APT. 2E",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "01843",
"telephone_number": "978-225-3249",
"fax_number": "844-432-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "187 MOUNT VERNON STREET",
"address_2": "APT. 2E",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "01843",
"telephone_number": "978-225-3249",
"fax_number": "844-432-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURPRENANT",
"first_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-05",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "2576",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "120235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "D'ONOFRIO",
"credential": "LICSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.