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NPI 1639862063

NPI 1639862063 : PSYCHOTHERAPY FOR INSIGHT AND CHANGE : NORTHAMPTON, MA

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General NPI Number Information
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    NPI Number           |    1639862063
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    Entity Type          |    Organization 
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    Legal Business Name  |    PSYCHOTHERAPY FOR INSIGHT AND CHANGE 
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Dates
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    Enumeration Date     |    05/31/2023
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    Last Update Date     |    05/31/2023
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Provider Practice Location Address
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    Address Line         |    206 STATE ST STE 1 
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    City                 |    NORTHAMPTON
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    State                |    MA
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    Zip                  |    01060-2264
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    Country              |    US
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    Telephone            |    646-207-0233
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    206 STATE ST STE 1 
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    City                 |    NORTHAMPTON
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    State                |    MA
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    Zip                  |    01060-2264
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CLINICAL DIRECTOR
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    Name                 |     RACHEL DRESS SNIDER 
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    Credential           |    LICSW
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    Telephone            |    646-207-0233
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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       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    
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    License Number State |    
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