Healthcare Provider Details

I. General information

NPI: 1619042496
Provider Name (Legal Business Name): THE ADD CENTER OF WESTERN MASSACHUSETTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MAPLE STREET SUITE 203
SPRINGFIELD MA
01105-1828
US

IV. Provider business mailing address

155 MAPLE STREET SUITE 203
SPRINGFIELD MA
01105-1828
US

V. Phone/Fax

Practice location:
  • Phone: 413-734-2800
  • Fax: 413-739-1652
Mailing address:
  • Phone: 413-734-2800
  • Fax: 413-739-1652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MITCHELL I CLIONSKY
Title or Position: PRESIDENT DIRECTOR
Credential:
Phone: 413-734-2800