Healthcare Provider Details

I. General information

NPI: 1831911098
Provider Name (Legal Business Name): NEXT STAGE COUNSELING & CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 02/09/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 DWIGHT RD STE 303K
LONGMEADOW MA
01106-1576
US

IV. Provider business mailing address

175 DWIGHT RD STE 303K
LONGMEADOW MA
01106-1576
US

V. Phone/Fax

Practice location:
  • Phone: 413-626-5065
  • Fax: 413-217-0422
Mailing address:
  • Phone: 413-626-5065
  • Fax: 413-217-0422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GLEIDY LIZ MARIA
Title or Position: CO-FOUNDER / THERAPIST
Credential: LICSW
Phone: 413-626-5065