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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 6 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.

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Identifiers

StateTypeNumberIssuer
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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