Healthcare Provider Details

I. General information

NPI: 1528759842
Provider Name (Legal Business Name): VALLEY RAINBOW MENTAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 UNION ST STE 101
EASTHAMPTON MA
01027-4100
US

IV. Provider business mailing address

123 UNION ST SUITE 101, OFFICE 7
EASTHAMPTON MA
01027
US

V. Phone/Fax

Practice location:
  • Phone: 413-341-0143
  • Fax:
Mailing address:
  • Phone: 413-341-0143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DANIELLE MARBLE
Title or Position: OWNER
Credential: LICSW
Phone: 413-341-0143