Healthcare Provider Details

I. General information

NPI: 1609921873
Provider Name (Legal Business Name): COUNSELING CENTER IN THE BERKSHIRES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 DEPOT ST STE 201
PITTSFIELD MA
01201-5130
US

IV. Provider business mailing address

34 DEPOT ST STE 201
PITTSFIELD MA
01201-5130
US

V. Phone/Fax

Practice location:
  • Phone: 413-499-4090
  • Fax: 413-499-1844
Mailing address:
  • Phone: 413-499-4090
  • Fax: 413-499-1844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number183317
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6646
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number2157
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4448
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4011
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8079
License Number StateMA
# 7
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8089
License Number StateMA
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1016218
License Number StateMA
# 9
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106585
License Number StateMA
# 10
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1027604
License Number StateMA

VIII. Authorized Official

Name: DR. AARON SARDELL
Title or Position: EXECUTIVE DIRECTOR
Credential: PSY.D.
Phone: 413-499-4090