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NPI Code Detail

MEDICARE: MR. ANGELO PANANAS LMHC

MEDICARE: MR. ANGELO PANANAS LMHC
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
1101YM0800XMental Health Counselor6034MA

General Provider Information

NPI Number : 1841407145
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANGELO PANANAS LMHC
Provider Business Mailing Address
First Line : 752 NORTH RD
Second Line :
City : WESTFIELD
State : MA
Zip : 01085-9724
Country : US
Telephone Number : 413-896-8436
Fax Number :
Provider Business Practice Location Address
First Line : 10 CENTRAL ST
Second Line : SUITE 27
City : WEST SPRINGFIELD
State : MA
Zip : 01089-2700
Country : US
Telephone Number : 413-732-0055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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Directions to “ MR. ANGELO PANANAS LMHC” Practice Location

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