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NPI Code Detail

MEDICARE: ELIZABETH DIAZ

MEDICARE: ELIZABETH DIAZ
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1689113318
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH DIAZ
Provider Business Mailing Address
First Line : 510 WELLINGTON HILL RD
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-6461
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100A HAVERHILL ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-4297
Country : US
Telephone Number : 978-682-5276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2017
Last Update Date : 12/07/2020

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1437611688 — DANIELLE NICOLE CARROLL LMHC
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Directions to “ ELIZABETH DIAZ ” Practice Location

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