Healthcare Provider Details
I. General information
NPI: 1114715265
Provider Name (Legal Business Name): NEIGHBORHOOD GROWTH COLLABORATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US
IV. Provider business mailing address
9 GLEN RAIN RD
DAYVILLE CT
06241-1853
US
V. Phone/Fax
- Phone: 508-640-5733
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CYNTHIA
C
WILLIAMS
Title or Position: EXECUTIVE DIRECTOR
Credential: MA, LMHC
Phone: 508-640-5733