Basic Information
| Provider Information | |||||||||
| NPI: | 1700945656 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREATER SPRINGFIELD COUNSELING, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 DWIGHT RD | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | LONGMEADOW | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011061761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135679993 | ||||||||
| FaxNumber: | 4135679993 | ||||||||
| Practice Location | |||||||||
| Address1: | 175 DWIGHT RD | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | LONGMEADOW | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011061761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135679993 | ||||||||
| FaxNumber: | 4135679993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4135679993 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.