Healthcare Provider Details

I. General information

NPI: 1861631046
Provider Name (Legal Business Name): DANIELLA L. THOMAS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2009
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 HILLSIDE LN
HAMPDEN MA
01036-9677
US

IV. Provider business mailing address

18 HILLSIDE LN
HAMPDEN MA
01036-9677
US

V. Phone/Fax

Practice location:
  • Phone: 413-896-4402
  • Fax:
Mailing address:
  • Phone: 413-896-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6520
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: