Healthcare Provider Details

I. General information

NPI: 1245144831
Provider Name (Legal Business Name): ELIZABETH LAWSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 WINSOR AVE
WATERTOWN MA
02472-1482
US

IV. Provider business mailing address

137 WINSOR AVE
WATERTOWN MA
02472-1482
US

V. Phone/Fax

Practice location:
  • Phone: 817-889-6086
  • Fax:
Mailing address:
  • Phone: 817-889-6086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number230922
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: