Healthcare Provider Details

I. General information

NPI: 1437066362
Provider Name (Legal Business Name): MARIA T CANCEL LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1456 CAREW ST
SPRINGFIELD MA
01104-2151
US

IV. Provider business mailing address

1456 CAREW ST
SPRINGFIELD MA
01104-2151
US

V. Phone/Fax

Practice location:
  • Phone: 413-735-3981
  • Fax: 413-301-6007
Mailing address:
  • Phone: 413-735-3981
  • Fax: 413-301-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: