Healthcare Provider Details

I. General information

NPI: 1891270120
Provider Name (Legal Business Name): HOLISTIC ALLIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 MAIN ST STE 415
SPRINGFIELD MA
01103-1440
US

IV. Provider business mailing address

174 SOUTH RD STE 106
ENFIELD CT
06082-4414
US

V. Phone/Fax

Practice location:
  • Phone: 413-459-8655
  • Fax: 413-455-2708
Mailing address:
  • Phone: 860-698-0782
  • Fax: 413-455-2708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA ENID ROMAN MORALES
Title or Position: CEO
Credential:
Phone: 413-459-8655