Healthcare Provider Details

I. General information

NPI: 1578394102
Provider Name (Legal Business Name): ASHLEY G CHAFFEE JR. MSN, RN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 GLENN DR
PITTSFIELD MA
01201-1712
US

IV. Provider business mailing address

4 GLENN DR
PITTSFIELD MA
01201-1712
US

V. Phone/Fax

Practice location:
  • Phone: 413-464-8203
  • Fax:
Mailing address:
  • Phone: 413-464-2325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2295354
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: