Healthcare Provider Details

I. General information

NPI: 1376482414
Provider Name (Legal Business Name): ALEXIS OSGERBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 CHESTNUT ST
SPRINGFIELD MA
01107-2007
US

IV. Provider business mailing address

471 CHESTNUT ST
SPRINGFIELD MA
01107-2007
US

V. Phone/Fax

Practice location:
  • Phone: 413-733-1431
  • Fax:
Mailing address:
  • Phone: 413-733-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: