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General NPI Number Information
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NPI Number | 1518390418
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Entity Type | Individual
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Provider Name | JOHN CARLOS MACHADO II
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Gender | Male
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 246 PARK ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-3314
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Country | US
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Telephone | 413-726-3557
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Fax |
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Provider Business Mailing Address
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Address Line | 5 HIGHLAND ST APT. B10
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1360
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Country | US
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Telephone | 860-604-0905
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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