Healthcare Provider Details

I. General information

NPI: 1740496371
Provider Name (Legal Business Name): MICHAEL CHILDS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 WEST ST SUITE C
AMHERST MA
01002-2967
US

IV. Provider business mailing address

441 WEST ST SUITE C
AMHERST MA
01002-2997
US

V. Phone/Fax

Practice location:
  • Phone: 413-253-0800
  • Fax: 413-253-0644
Mailing address:
  • Phone: 413-253-0800
  • Fax: 413-253-0644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY 4632-PR
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY 4632-PR
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY 4632-PR
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPY 4632-PR
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPY 4632-PR
License Number StateMA
# 6
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPY 4632-PR
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: