Healthcare Provider Details

I. General information

NPI: 1659078228
Provider Name (Legal Business Name): FAITH EVAN DORGAN-HALLIDAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 PARK ST
WEST SPRINGFIELD MA
01089-3314
US

IV. Provider business mailing address

30 ROBINSON RD
WEST SPRINGFIELD MA
01089-2933
US

V. Phone/Fax

Practice location:
  • Phone: 413-737-4718
  • Fax:
Mailing address:
  • Phone: 413-563-5622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: