Provider Demographics
NPI:1154454536
Name:PILACHOWSKI, DANIEL M (LICSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:PILACHOWSKI
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 UNION ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-4123
Mailing Address - Country:US
Mailing Address - Phone:413-731-5582
Mailing Address - Fax:413-731-7999
Practice Address - Street 1:380 UNION ST
Practice Address - Street 2:SUITE 116
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4123
Practice Address - Country:US
Practice Address - Phone:413-731-5582
Practice Address - Fax:413-731-7999
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10293051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1890026OtherMBHP
MA000000020410OtherBMC HEALTH NET