Provider Demographics
NPI:1114451838
Name:BROMFIELD, VALRI
Entity Type:Individual
Prefix:
First Name:VALRI
Middle Name:
Last Name:BROMFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALRI
Other - Middle Name:
Other - Last Name:BROMFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCMHSP LMHC
Mailing Address - Street 1:32 TEXEL DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2638
Mailing Address - Country:US
Mailing Address - Phone:615-944-6695
Mailing Address - Fax:
Practice Address - Street 1:32 TEXEL DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-2638
Practice Address - Country:US
Practice Address - Phone:615-944-6695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9679101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health