Putelis, Elizabeth Ann
Putelis, Elizabeth Ann is an individual health care provider with primary practice located at 330 Sw Cutoff Ste 203 , Worcester MA 01604-2730. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Putelis, Elizabeth Ann can be contacted via phone (508) 341-2829.Contact Information
Primary practice address
330 Sw Cutoff Ste 203
Worcester MA 01604-2730
Phone: (508) 341-2829
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 2047 | Massachusetts |
Profile Details
| NPI number | 1033479068 |
|---|---|
| LBN Legal business name | Putelis, Elizabeth Ann |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2012 |
| Last updated | Apr 3rd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033479068 | NPPES |
| Massachusetts | Other | 042611055 | TAX ID |
| Massachusetts | Other | M18633 | TAX ID |
| Massachusetts | MEDICAID | 1303287 | TAX ID |
| Massachusetts | Other | 99618201 | TAX ID |
| Massachusetts | Other | 1004745 | TAX ID |
| Massachusetts | Other | 1303287 | TAX ID |
| Massachusetts | Other | 0000023532 | TAX ID |
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