Individual
ELIZABETH A CUSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
327 NEW DEHAVEN ST, CONSHOHOCKEN, PA 19428-2625
(215) 510-1891
Mailing address
327 NEW DEHAVEN ST, CONSHOHOCKEN, PA 19428-2625
(215) 510-1891
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
PC007432
PA
101YM0800X
Mental Health Counselor
PC007432
PA
101YP2500X
Professional Counselor
Primary
PC007432
PA
Other
Enumeration date
01/16/2013
Last updated
02/28/2016
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