Healthcare Provider Details

I. General information

NPI: 1154829745
Provider Name (Legal Business Name): ELIZABETH HARE M.ED., LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UMASS AMHERST CCPH, BARTLLETT HALL, 130 HICKS WAY
AMHERST MA
01003
US

IV. Provider business mailing address

99 SUMMER ST
AMHERST MA
01002-1121
US

V. Phone/Fax

Practice location:
  • Phone: 413-545-2337
  • Fax: 413-545-2337
Mailing address:
  • Phone: 413-626-7905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number221609
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: