Healthcare Provider Details

I. General information

NPI: 1568314219
Provider Name (Legal Business Name): CARMELLA RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 BIRNIE AVE
SPRINGFIELD MA
01107-1106
US

IV. Provider business mailing address

102 MAIN ST
GREENFIELD MA
01301-3275
US

V. Phone/Fax

Practice location:
  • Phone: 844-243-4357
  • Fax: 413-451-0037
Mailing address:
  • Phone: 844-243-4357
  • Fax: 413-451-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: