Healthcare Provider Details

I. General information

NPI: 1417852484
Provider Name (Legal Business Name): JOHNNY BONTEMPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 FENN ST
PITTSFIELD MA
01201-5286
US

IV. Provider business mailing address

29 DAWN DR
BECKET MA
01223-5711
US

V. Phone/Fax

Practice location:
  • Phone: 413-499-0412
  • 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 StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: