Healthcare Provider Details

I. General information

NPI: 1598593923
Provider Name (Legal Business Name): MONIQUE CORMIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 BIRNIE AVE
SPRINGFIELD MA
01107-1104
US

IV. Provider business mailing address

332 BIRNIE AVE
SPRINGFIELD MA
01107-1104
US

V. Phone/Fax

Practice location:
  • Phone: 978-544-2148
  • Fax:
Mailing address:
  • Phone: 978-544-2148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: