Healthcare Provider Details

I. General information

NPI: 1396780318
Provider Name (Legal Business Name): MICHELE FRANCES CRITELLI LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 10/29/2023
Certification Date: 10/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 PARK AVE
WEST SPRINGFIELD MA
01089
US

IV. Provider business mailing address

341 OLD ENFIELD RD
BELCHERTOWN MA
01007-9550
US

V. Phone/Fax

Practice location:
  • Phone: 413-788-8767
  • Fax: 413-788-8769
Mailing address:
  • Phone: 413-237-6217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number106598
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: