Basic Information
| Provider Information | |||||||||
| NPI: | 1023301587 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MENARD | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMHC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1205 4TH ST | ||||||||
| Address2: | |||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330403707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054347660 | ||||||||
| FaxNumber: | 3052926723 | ||||||||
| Practice Location | |||||||||
| Address1: | 1205 4TH ST | ||||||||
| Address2: | |||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330403707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054347660 | ||||||||
| FaxNumber: | 3052926723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2011 | ||||||||
| LastUpdateDate: | 08/05/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MH11188 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.