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General NPI Number Information
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NPI Number | 1699224568
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Entity Type | Organization
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Legal Business Name | PIONEER VALLEY COUNSELING
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Dates
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Enumeration Date | 10/03/2016
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Last Update Date | 10/03/2016
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Provider Practice Location Address
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Address Line | 10 CENTER ST STE 408
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City | CHICOPEE
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State | MA
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Zip | 01013-2784
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Country | US
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Telephone | 413-222-9375
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Fax | 413-331-5395
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Provider Business Mailing Address
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Address Line | 10 CENTER ST STE 408
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City | CHICOPEE
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State | MA
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Zip | 01013-2784
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Country | US
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Telephone | 413-222-9375
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Fax | 413-331-5395
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Authorized Official
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Title or Position | OWNER
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Name | WENDY T KELLEHER
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Credential | LMFT
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Telephone | 413-222-9375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1417
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License Number State | MA
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