Healthcare Provider Details

I. General information

NPI: 1265188395
Provider Name (Legal Business Name): LEAH MONIQUE HASTINGS PMHNP -BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH MONIQUE WARREN

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 BOSTON PROVIDENCE TPKE STE 20
NORWOOD MA
02062-4649
US

IV. Provider business mailing address

45 LOWER WESTFIELD RD
HOLYOKE MA
01040-2747
US

V. Phone/Fax

Practice location:
  • Phone: 508-206-8578
  • Fax: 866-470-6528
Mailing address:
  • Phone: 413-315-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2309666
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: