Healthcare Provider Details

I. General information

NPI: 1083301675
Provider Name (Legal Business Name): HOLISTIC CARE MENTAL HEALTH ASSOCIATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 UNION ST STE 42
WEST SPRINGFIELD MA
01089-3485
US

IV. Provider business mailing address

221B WOLLASTON ST
SPRINGFIELD MA
01119-1673
US

V. Phone/Fax

Practice location:
  • Phone: 413-930-4562
  • Fax: 413-707-9931
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PAMELA JUMBA
Title or Position: OWNER/PROVIDER
Credential: MSW
Phone: 413-306-8605