Healthcare Provider Details

I. General information

NPI: 1699966846
Provider Name (Legal Business Name): SPECIALIZED COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 HAZARD AVE STE 262
ENFIELD CT
06082-3845
US

IV. Provider business mailing address

380 UNION ST. STE. 116
WEST SPRINGFIELD MA
01089
US

V. Phone/Fax

Practice location:
  • Phone: 413-731-5582
  • Fax: 413-731-7999
Mailing address:
  • Phone: 413-731-5582
  • Fax: 413-731-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number006650
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1029305
License Number StateMA

VIII. Authorized Official

Name: MR. DANIEL M PILACHOWSKI
Title or Position: PRESIDENT/CLINICAL DIR
Credential: MSW
Phone: 413-731-5582