Healthcare Provider Details

I. General information

NPI: 1679497838
Provider Name (Legal Business Name): EBSWORTH VOICE WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

IV. Provider business mailing address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

V. Phone/Fax

Practice location:
  • Phone: 617-379-2086
  • Fax:
Mailing address:
  • Phone: 617-379-2086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LARS NICOLE EBSWORTH
Title or Position: CEO
Credential: M.S. CCC-SLP
Phone: 617-379-2086