Provider Demographics
NPI:1871958959
Name:LAND, ELIZABETH (LMHC, MS, M ED)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LAND
Suffix:
Gender:F
Credentials:LMHC, MS, M ED
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:LAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, MS, M ED
Mailing Address - Street 1:31 LAVENDER LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01129-1708
Mailing Address - Country:US
Mailing Address - Phone:413-358-2265
Mailing Address - Fax:
Practice Address - Street 1:31 LAVENDER LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01129-1708
Practice Address - Country:US
Practice Address - Phone:413-358-2265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC5000197101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional