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General NPI Number Information
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NPI Number | 1407463789
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Entity Type | Individual
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Provider Name | MAXWELL EHRNFELT LICSW
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Gender | Male
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 16 CENTER ST STE 517
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3031
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Country | US
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Telephone | 413-624-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 43 FIRGLADE AVE
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City | SPRINGFIELD
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State | MA
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Zip | 01108-2503
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Country | US
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Telephone | 413-251-9906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LICSW1121141
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License Number State | MA
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