Healthcare Provider Details

I. General information

NPI: 1568889343
Provider Name (Legal Business Name): FRANKIE VERA LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 BENTON ST
SPRINGFIELD MA
01109-2711
US

IV. Provider business mailing address

54 BENTON ST
SPRINGFIELD MA
01109-2711
US

V. Phone/Fax

Practice location:
  • Phone: 939-363-1411
  • Fax:
Mailing address:
  • Phone: 939-363-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10004436
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: