Healthcare Provider Details

I. General information

NPI: 1841206810
Provider Name (Legal Business Name): KEVIN DALE BLANCHARD MSW, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CHAPMAN ST
GREENFIELD MA
01301-2415
US

IV. Provider business mailing address

467 HILL RD P.O.BOX 74
ASHFIELD MA
01330-9759
US

V. Phone/Fax

Practice location:
  • Phone: 413-628-4593
  • Fax: 413-773-0477
Mailing address:
  • Phone: 413-628-3882
  • Fax: 413-773-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1030843
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1030843
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: