Healthcare Provider Details

I. General information

NPI: 1295829828
Provider Name (Legal Business Name): JANET LOUISE PORCELLI LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 RIDDELL ST SUITE 8
GREENFIELD MA
01301-2025
US

IV. Provider business mailing address

PO BOX 1036
GREENFIELD MA
01302-1036
US

V. Phone/Fax

Practice location:
  • Phone: 413-548-6217
  • Fax: 413-773-9484
Mailing address:
  • Phone: 413-548-6217
  • Fax: 413-773-9484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number110688
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: