Healthcare Provider Details

I. General information

NPI: 1174458202
Provider Name (Legal Business Name): DARIAN GONZALEZ
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 EXCHANGE ST
CHICOPEE MA
01013-1679
US

IV. Provider business mailing address

69 NOTRE DAME ST
SPRINGFIELD MA
01104-2112
US

V. Phone/Fax

Practice location:
  • Phone: 413-594-2141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: