Healthcare Provider Details

I. General information

NPI: 1396801684
Provider Name (Legal Business Name): MICHELLE BARBARA CALIENTO M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 WEST AVE SUITE 102 & 104
LUDLOW MA
01056-1700
US

IV. Provider business mailing address

30 HOLLAND DR
E LONGMEADOW MA
01028-1419
US

V. Phone/Fax

Practice location:
  • Phone: 413-583-6750
  • Fax: 413-589-7001
Mailing address:
  • Phone: 413-525-5702
  • Fax: 413-589-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: