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NPI Code Detail

MEDICARE: PATRICIA BOUFFARD LCSW

MEDICARE: PATRICIA BOUFFARD LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker227357MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1227357OTHERMALICENSED CERTIFIED SOCIAL WORKER

General Provider Information

NPI Number : 1053618983
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA BOUFFARD LCSW
Provider Business Mailing Address
First Line : 50 COMMERCIAL ST
Second Line :
City : HOLYOKE
State : MA
Zip : 01040-4704
Country : US
Telephone Number : 203-695-9290
Fax Number :
Provider Business Practice Location Address
First Line : 50 COMMERCIAL ST
Second Line :
City : HOLYOKE
State : MA
Zip : 01040-4704
Country : US
Telephone Number : 413-707-0861
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2011
Last Update Date : 09/20/2022

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Directions to “ PATRICIA BOUFFARD LCSW” Practice Location

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