Healthcare Provider Details

I. General information

NPI: 1164290722
Provider Name (Legal Business Name): PEGGY AVALLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 BROOKER HILL RD
BECKET MA
01223-9784
US

IV. Provider business mailing address

343 BROOKER HILL RD
BECKET MA
01223-9784
US

V. Phone/Fax

Practice location:
  • Phone: 413-446-5731
  • Fax:
Mailing address:
  • Phone: 413-446-5731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLCSW230811
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: