Healthcare Provider Details

I. General information

NPI: 1962634626
Provider Name (Legal Business Name): MARTIN SETH KOUNITZ MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CONWAY ST
GREENFIELD MA
01301-1521
US

IV. Provider business mailing address

329 CONWAY ST
GREENFIELD MA
01301-1521
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-6301
  • Fax: 866-644-0871
Mailing address:
  • Phone: 413-774-6301
  • Fax: 866-644-0871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: