Provider Demographics
NPI:1144569005
Name:KOONZ CORTES, CHELSEA M (LICSW)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:KOONZ CORTES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:KOONZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1353
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01302-1353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 SHATTUCK ST APT 1
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1903
Practice Address - Country:US
Practice Address - Phone:617-981-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1220511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical