Healthcare Provider Details

I. General information

NPI: 1881949022
Provider Name (Legal Business Name): JAIME LEIGH MOORE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIME LEIGH LAPIERRE LMHC

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 LOCUST ST STE 2
NORTHAMPTON MA
01060
US

IV. Provider business mailing address

764 PENDLETON AVE
CHICOPEE MA
01020-2950
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-8700
  • Fax: 413-584-1714
Mailing address:
  • Phone: 413-530-6099
  • Fax:

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: