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General NPI Number Information
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NPI Number | 1568067668
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Entity Type | Individual
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Provider Name | ADAM G BLEFARI PSY.D, NCSP
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Gender | Male
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 269 1ST ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-4727
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Country | US
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Telephone | 413-499-9515
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Fax | 413-499-9559
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Provider Business Mailing Address
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Address Line | 21 RIVERVIEW DR
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City | DALTON
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State | MA
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Zip | 01226-1312
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Country | US
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Telephone | 413-250-0134
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 5416
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 506976
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 11295
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License Number State | MA
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