Healthcare Provider Details

I. General information

NPI: 1063436467
Provider Name (Legal Business Name): JEWISH FAMILY SERVICE OF WESTERN MASSACHUSETTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 LENOX ST.
SPRINGFIELD MA
01108-2666
US

IV. Provider business mailing address

15 LENOX ST.
SPRINGFIELD MA
01108-2666
US

V. Phone/Fax

Practice location:
  • Phone: 413-737-2601
  • Fax: 413-737-0323
Mailing address:
  • Phone: 413-737-2601
  • Fax: 413-737-0323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN D. REINIGER
Title or Position: DIRECTOR OF CLINICAL SERVICES
Credential: MSW, LICSW
Phone: 413-455-1936