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General NPI Number Information
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NPI Number | 1225223753
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL &COUNSELING SERVICE ASSOCIATES
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 80 CONGRESS ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104-3427
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Country | US
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Telephone | 413-732-1220
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Fax | 413-732-1228
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Provider Business Mailing Address
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Address Line | 80 CONGRESS ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104-3427
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Country | US
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Telephone | 413-732-1220
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Fax | 413-732-1228
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | MS. BRUNILDA DELEON
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Credential | ED.D
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Telephone | 413-736-0395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6342
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License Number State | MA
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