Provider Demographics
NPI:1053699843
Name:PILLARD, ELIZABETH JANE (LICSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JANE
Last Name:PILLARD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UHC, ARNOLD 3
Mailing Address - Street 2:1 SOUTH PROSPECT ST.
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-847-9759
Mailing Address - Fax:
Practice Address - Street 1:UHC, ARNOLD 3
Practice Address - Street 2:1 SOUTH PROSPECT ST.
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:808-847-9759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.00008761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical