Provider Demographics
NPI:1730156555
Name:SALEM, ELIA AWWAD (LMHC)
Entity type:Individual
Prefix:MR
First Name:ELIA
Middle Name:AWWAD
Last Name:SALEM
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOSTON HEALTH CARE
Mailing Address - Street 2:STE 15
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081
Mailing Address - Country:US
Mailing Address - Phone:508-660-7949
Mailing Address - Fax:508-660-7943
Practice Address - Street 1:420 MAIN ST STE 15
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-3753
Practice Address - Country:US
Practice Address - Phone:508-660-1666
Practice Address - Fax:508-660-1667
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5285101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor