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General NPI Number Information
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NPI Number | 1730156555
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Entity Type | Individual
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Provider Name | ELIA AWWAD SALEM LMHC
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Gender | Male
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 420 MAIN ST STE 15
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City | WALPOLE
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State | MA
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Zip | 02081-3753
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Country | US
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Telephone | 508-660-1666
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Fax | 508-660-1667
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Provider Business Mailing Address
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Address Line | BOSTON HEALTH CARE STE 15
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City | WALPOLE
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State | MA
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Zip | 02081
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Country | US
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Telephone | 508-660-7949
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Fax | 508-660-7943
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5285
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License Number State |
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