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General NPI Number Information
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NPI Number | 1053174235
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Entity Type | Organization
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Legal Business Name | PSYCHIATRY AND PRIMARY CARE
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 15 BENTON DR STE 10
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-3232
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Country | US
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Telephone | 413-200-0769
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Fax | 877-421-3866
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Provider Business Mailing Address
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Address Line | 15 BENTON DR STE 10
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-3232
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Country | US
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Telephone | 413-200-0769
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Fax | 877-421-3866
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | KELVIN N KARANJA
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Credential |
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Telephone | 413-200-0769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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