Individual
CAROLYNN ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
(978) 408-8725
Mailing address
205 BURLINGTON RD, BEDFORD, MA 01730-1406
(978) 408-8725
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000023532
BMC
MA
01
—
042611055
TAX ID
MA
01
—
1004745
FALLON
MA
01
—
13033287
MBHP
MA
01
—
99618201
NETWORK HEALTH
MA
01
—
M18633
BCBS
MA
Enumeration date
01/03/2022
Last updated
08/19/2022
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