Provider Demographics
NPI:1114409265
Name:SIMOES SEEFELDT, SANDRA MONICA (DS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MONICA
Last Name:SIMOES SEEFELDT
Suffix:
Gender:F
Credentials:DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1699 DUBLIN RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MA
Mailing Address - Zip Code:01254-5085
Mailing Address - Country:US
Mailing Address - Phone:413-698-2633
Mailing Address - Fax:
Practice Address - Street 1:388 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4903
Practice Address - Country:US
Practice Address - Phone:413-499-4537
Practice Address - Fax:413-448-8223
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor