Healthcare Provider Details

I. General information

NPI: 1417023672
Provider Name (Legal Business Name): WILLIAMSTOWN BEHAVIORAL HEALTH ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 HOSPITAL AVE STE 214
NORTH ADAMS MA
01247-2538
US

IV. Provider business mailing address

681 SIMONDS RD
WILLIAMSTOWN MA
01267
US

V. Phone/Fax

Practice location:
  • Phone: 413-398-5064
  • Fax: 413-398-5496
Mailing address:
  • Phone: 413-458-9600
  • Fax: 413-458-4028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JEREMY RAY SULLIVAN
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 413-398-5064