Basic Information
| Provider Information | |||||||||
| NPI: | 1063852424 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VADNAIS | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61 PROSPECT ST | ||||||||
| Address2: | |||||||||
| City: | WESTFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010851555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4138278959 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | NORTHBOROUGH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135356877 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2013 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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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 | 9234 | MA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.