Healthcare Provider Details

I. General information

NPI: 1558674929
Provider Name (Legal Business Name): CLINICAL AND SUPPORT OPTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 HIGH ST
GREENFIELD MA
01301-2702
US

IV. Provider business mailing address

111 FEDERAL ST
GREENFIELD MA
01301-2501
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6553
License Number StateMA

VIII. Authorized Official

Name: MS. KARIN JEFFERS
Title or Position: CEO
Credential: LMHC
Phone: 413-774-1312