Elizabeth Prostak, LCSW
Social Worker, Clinical in Brockton, MA. Individual provider (NPI-1).
NPI number1982147526
StatusActive
Last updated in NPPESDec 30, 2024
Details
- NPI
- 1982147526
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Prostak
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 30, 2016
- Certification date
- Dec 30, 2024
- Last updated
- Dec 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 126846 | MA | Yes |
| 104100000X | Social Worker | 000226675 | MA |
Practice location
20 Meadowbrook RdBrockton, MA 02301-7122
Phone 508-580-0801
Mailing address
14 Fordham RdAllston, MA 02134-3000
Phone 617-782-6469 · Fax 781-848-0206
Other practice locations
14 Fordham Rd
Allston, MA 02134-3000
Allston, MA 02134-3000
Phone 617-782-6460 · Fax 781-848-0206
680 Centre St
Brockton, MA 02302-3308
Brockton, MA 02302-3308
Phone 508-941-7150
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