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General NPI Number Information
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NPI Number | 1548476757
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Entity Type | Individual
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Provider Name | PETER COPELAND BOTT MSW
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 50 PLEASANT ST
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3909
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Country | US
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Telephone | 413-585-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 14 ASHFIELD LN
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City | SOUTH HADLEY
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State | MA
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Zip | 01075-1321
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Country | US
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Telephone | 413-536-4826
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 116400
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License Number State | MA
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