=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689926354
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY L SOFTIC LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2012
-----------------------------------------------------
Last Update Date | 01/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 329 CONWAY ST
-----------------------------------------------------
City | GREENFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01301-1521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-774-6301
-----------------------------------------------------
Fax | 866-644-0871
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 329 CONWAY ST
-----------------------------------------------------
City | GREENFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01301-1521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-774-6301
-----------------------------------------------------
Fax | 866-644-0871
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 11755
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------