Healthcare Provider Details

I. General information

NPI: 1811471154
Provider Name (Legal Business Name): BRIAN P CAHILLANE M.S., J.D., LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2018
Last Update Date: 09/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

577 WESTERN AVENUE
WESTFIELD MA
01086-1630
US

IV. Provider business mailing address

39 ABBEY ST
SOUTH HADLEY MA
01075-2601
US

V. Phone/Fax

Practice location:
  • Phone: 413-572-5790
  • Fax:
Mailing address:
  • Phone: 413-575-9954
  • Fax: 413-437-7974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119502
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: