Healthcare Provider Details

I. General information

NPI: 1083138259
Provider Name (Legal Business Name): MISS AMY ELIZABETH FIMBEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 EXCHANGE ST
CHICOPEE MA
01013-1679
US

IV. Provider business mailing address

34 CARPENTER AVE
CHICOPEE MA
01020-4958
US

V. Phone/Fax

Practice location:
  • Phone: 413-593-2141
  • Fax:
Mailing address:
  • Phone: 413-668-5065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10003995
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: