MEDICARE: ELIZABETH ELHARIS DAKAVANA LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0680000116	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649324617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ELHARIS DAKAVANA LCMHC

Provider Business Mailing Address
First Line	:	105 HIGHLAND STREET
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301
Country	:	US
Telephone Number	:	802-254-6860
Fax Number	:	802-254-6860

Provider Business Practice Location Address
First Line	:	105 HIGHLAND STREET
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301
Country	:	US
Telephone Number	:	802-254-6860
Fax Number	:	802-254-6860

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	02/22/2026

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