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General NPI Number Information
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NPI Number | 1821783531
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Entity Type | Organization
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Legal Business Name | TRI-STATE PSYCHOTHERAPY GROUP LLC
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Dates
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Enumeration Date | 04/07/2023
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Last Update Date | 07/29/2023
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Provider Practice Location Address
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Address Line | 75 SOUTH CHURCH ST. 6TH FLOOR SUITE 22
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City | PITTSFIELD
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State | MA
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Zip | 01201-6941
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Country | US
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Telephone | 413-224-8716
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Fax |
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Provider Business Mailing Address
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Address Line | 75 SOUTH CHURCH ST. 6TH FLOOR SUITE 22
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City | PITTSFIELD
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State | MA
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Zip | 01201-6941
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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 | CEO/FOUNDER
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Name | MELANIE R SNYDER
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Credential | LICSW
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Telephone | 518-301-3343
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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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