Healthcare Provider Details

I. General information

NPI: 1740353929
Provider Name (Legal Business Name): TERESA HODEL MALINOFSKY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERESA HODEL-MALINOFSKY PHD

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 NORTH MAIN STREET BUILDING 1, MENTAL HEALTH
LEEDS MA
01053
US

IV. Provider business mailing address

19 CENTER CT
NORTHAMPTON MA
01060-3502
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-4040
  • Fax:
Mailing address:
  • Phone: 413-586-3089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6488
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6488
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6488
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: