Healthcare Provider Details

I. General information

NPI: 1083460117
Provider Name (Legal Business Name): OWL AND OAK COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MAIN ST STE 40
NORTHAMPTON MA
01060-4279
US

IV. Provider business mailing address

150 MAIN ST STE 40
NORTHAMPTON MA
01060-4279
US

V. Phone/Fax

Practice location:
  • Phone: 413-530-9777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA CROWLEY
Title or Position: OWNER
Credential: LICSW
Phone: 413-530-9777