Provider Demographics
NPI:1902166689
Name:LARAIA, ELIZABETH CATHERINE (MSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CATHERINE
Last Name:LARAIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E BUCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370-9407
Mailing Address - Country:US
Mailing Address - Phone:781-799-9624
Mailing Address - Fax:
Practice Address - Street 1:203 EAST ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1234
Practice Address - Country:US
Practice Address - Phone:781-799-9624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical