Healthcare Provider Details

I. General information

NPI: 1497692024
Provider Name (Legal Business Name): EMMETT DUPONT
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: SKYLER DUPONT

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 NORWOOD TER
HOLYOKE MA
01040-1758
US

IV. Provider business mailing address

157 NORWOOD TER
HOLYOKE MA
01040-1758
US

V. Phone/Fax

Practice location:
  • Phone: 860-884-5829
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCSW2142785
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: