Healthcare Provider Details

I. General information

NPI: 1033653951
Provider Name (Legal Business Name): MEGHAN L D'ANGELO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 MILL ST
WESTFIELD MA
01085-4598
US

IV. Provider business mailing address

77 MILL ST
WESTFIELD MA
01085-4598
US

V. Phone/Fax

Practice location:
  • Phone: 413-568-1421
  • Fax:
Mailing address:
  • Phone: 413-568-1421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: