Healthcare Provider Details

I. General information

NPI: 1285160960
Provider Name (Legal Business Name): MARIA GEORGES LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 RIVERDALE ST # 1101
WEST SPRINGFIELD MA
01089-4615
US

IV. Provider business mailing address

1129 RIVERDALE ST # 1101
WEST SPRINGFIELD MA
01089-4615
US

V. Phone/Fax

Practice location:
  • Phone: 413-271-5133
  • Fax:
Mailing address:
  • Phone: 413-271-5133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number121972
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: