Healthcare Provider Details

I. General information

NPI: 1700322161
Provider Name (Legal Business Name): SARA ANNA SUBOCZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ARCH PL
GREENFIELD MA
01301-2457
US

IV. Provider business mailing address

11 N ST
TURNERS FALLS MA
01376-1806
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-5411
  • Fax: 413-773-8429
Mailing address:
  • Phone: 413-774-5411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128140
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: