Healthcare Provider Details

I. General information

NPI: 1497034219
Provider Name (Legal Business Name): SAMANTHA MACHADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAMANTHA OSOWSKI

II. Dates (important events)

Enumeration Date: 08/10/2011
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SILVER ST UNIT 216
AGAWAM MA
01001-3067
US

IV. Provider business mailing address

200 SILVER ST UNIT 216
AGAWAM MA
01001-3067
US

V. Phone/Fax

Practice location:
  • Phone: 413-636-6010
  • Fax:
Mailing address:
  • Phone: 413-636-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: