Healthcare Provider Details

I. General information

NPI: 1558487199
Provider Name (Legal Business Name): JAMES COUNSELING ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 MAIN ST
WILBRAHAM MA
01095
US

IV. Provider business mailing address

919 MAIN ST
WILBRAHAM MA
01095
US

V. Phone/Fax

Practice location:
  • Phone: 413-596-9059
  • Fax: 413-596-2366
Mailing address:
  • Phone: 413-596-9059
  • Fax: 413-596-2366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number104485
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. SUSAN W JAMES
Title or Position: LICENSED INDEPENDENT CLINICAL SOCIA
Credential: MSW
Phone: 413-596-9059