Healthcare Provider Details

I. General information

NPI: 1063932549
Provider Name (Legal Business Name): PAULETTE MARIE BERROCALES MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 COMMERCIAL ST
HOLYOKE MA
01040-4704
US

IV. Provider business mailing address

511 E COLUMBUS AVE
SPRINGFIELD MA
01105-2506
US

V. Phone/Fax

Practice location:
  • Phone: 413-846-0445
  • Fax:
Mailing address:
  • Phone: 413-827-8959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1142769
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: